Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.79 / $295.67 / $554.70	Facility		$35.79	$295.67	$554.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.67 / $12.51 / $14.81	Facility	26	$7.67	$12.51	$14.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.87 / $30.42 / $318.52	Facility	TC	$18.87	$30.42	$318.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.05 / $33.61 / $69.94	Professional		$24.05	$33.61	$69.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $9.94 / $43.68	Professional	26	$7.52	$9.94	$43.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $19.48 / $38.03	Professional	TC	$16.34	$19.48	$38.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $20.10 / $27.36	Professional		$18.18	$20.10	$27.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.51 / $11.49	Professional	26	$6.19	$8.51	$11.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $23.56 / $27.02	Professional	TC	$16.75	$23.56	$27.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $111.45 / $308.01	Facility		$54.95	$111.45	$308.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.65 / $32.65 / $57.46	Professional		$10.65	$32.65	$57.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.17 / $61.74 / $159.11	Facility		$36.17	$61.74	$159.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.42 / $38.27 / $58.46	Professional		$23.42	$38.27	$58.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.48 / $18.39	Professional	26	$7.36	$11.48	$18.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.32 / $26.69 / $42.04	Professional	TC	$16.32	$26.69	$42.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $48.20 / $168.14	Professional		$32.60	$48.20	$168.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.21 / $14.47 / $69.86	Professional	26	$10.21	$14.47	$69.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.84 / $31.61 / $107.65	Professional	TC	$20.84	$31.61	$107.65
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 $33.24 / $33.58 / $36.86	Professional		$33.24	$33.58	$36.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $10.41 / $11.06	Professional	26	$10.10	$10.41	$11.06
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.83 / $23.48 / $25.81	Professional	TC	$22.83	$23.48	$25.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.57 / $32.34 / $38.56	Professional		$11.57	$32.34	$38.56
United Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $34.36 / $55.97	Professional		$27.16	$34.36	$55.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.65 / $17.28	Professional	26	$8.64	$11.65	$17.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.11 / $24.49 / $40.20	Professional	TC	$18.11	$24.49	$40.20