Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $304.98 / $506.21	Facility		$41.96	$304.98	$506.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.61 / $12.99 / $18.92	Facility	26	$8.61	$12.99	$18.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.80 / $34.38 / $221.07	Facility	TC	$20.80	$34.38	$221.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $37.53 / $94.93	Professional		$28.42	$37.53	$94.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $11.53 / $57.89	Professional	26	$8.74	$11.53	$57.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $23.81 / $43.69	Professional	TC	$19.37	$23.81	$43.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.20 / $29.75 / $40.46	Professional		$22.20	$29.75	$40.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $9.27 / $13.24	Professional	26	$7.09	$9.27	$13.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.87 / $26.96 / $26.96	Professional	TC	$19.87	$26.96	$26.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.22 / $128.19 / $325.35	Facility		$72.22	$128.19	$325.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.28 / $38.42 / $67.59	Professional		$12.28	$38.42	$67.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $67.29 / $187.88	Facility		$38.90	$67.29	$187.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $44.62 / $67.79	Professional		$27.61	$44.62	$67.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $13.74 / $21.67	Professional	26	$8.40	$13.74	$21.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $30.92 / $45.38	Professional	TC	$19.28	$30.92	$45.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $56.61 / $150.82	Professional		$38.35	$56.61	$150.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $16.70 / $68.33	Professional	26	$11.77	$16.70	$68.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.49 / $36.78 / $96.25	Professional	TC	$23.49	$36.78	$96.25
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $39.68 / $43.29	Professional		$39.10	$39.68	$43.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $12.06 / $12.75	Professional	26	$11.77	$12.06	$12.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.04 / $27.91 / $30.54	Professional	TC	$27.04	$27.91	$30.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.34 / $32.34 / $45.29	Professional		$13.34	$32.34	$45.29
United Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $41.59 / $60.50	Professional		$31.17	$41.59	$60.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $13.17 / $20.14	Professional	26	$10.29	$13.17	$20.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $27.96 / $41.75	Professional	TC	$21.02	$27.96	$41.75