Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.62 / $301.94 / $477.23	Facility		$45.62	$301.94	$477.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.50 / $14.30 / $18.92	Facility	26	$9.50	$14.30	$18.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $35.61 / $78.13	Professional		$25.34	$35.61	$78.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.72 / $62.05	Professional	26	$9.41	$12.72	$62.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.17 / $45.58	Professional	TC	$19.76	$25.17	$45.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $33.08 / $37.04	Professional		$26.59	$33.08	$37.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $10.15 / $14.58	Professional	26	$7.97	$10.15	$14.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $120.60 / $362.09	Facility		$67.95	$120.60	$362.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.51 / $42.64 / $81.73	Professional		$13.51	$42.64	$81.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.10 / $76.14 / $209.06	Facility		$37.10	$76.14	$209.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $47.67 / $69.06	Professional		$28.93	$47.67	$69.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $14.58 / $22.77	Professional	26	$9.08	$14.58	$22.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.20 / $32.67 / $48.87	Professional	TC	$20.20	$32.67	$48.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $60.08 / $153.06	Professional		$41.02	$60.08	$153.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $18.39 / $64.87	Professional	26	$13.01	$18.39	$64.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $41.25 / $95.48	Professional	TC	$28.61	$41.25	$95.48
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.39 / $44.14 / $48.01	Professional		$43.39	$44.14	$48.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $13.29 / $14.04	Professional	26	$13.01	$13.29	$14.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.11 / $31.12 / $33.97	Professional	TC	$30.11	$31.12	$33.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.69 / $32.34 / $50.22	Professional		$14.69	$32.34	$50.22
United Facility/Professional Professional Modifier Low / Median / High Price $33.09 / $43.94 / $66.67	Professional		$33.09	$43.94	$66.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $15.78 / $29.77	Professional	26	$11.18	$15.78	$29.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $29.72 / $46.22	Professional	TC	$22.08	$29.72	$46.22