Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.41 / $324.24 / $477.31	Facility		$45.41	$324.24	$477.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.36 / $10.70 / $14.21	Facility	26	$7.36	$10.70	$14.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.20 / $35.14 / $244.42	Facility	TC	$22.20	$35.14	$244.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.35 / $32.33 / $73.13	Professional		$14.35	$32.33	$73.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $10.02 / $39.90	Professional	26	$7.18	$10.02	$39.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.28 / $43.13	Professional	TC	$18.82	$23.28	$43.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $26.50 / $34.90	Professional		$19.10	$26.50	$34.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.65 / $7.85 / $10.98	Professional	26	$5.65	$7.85	$10.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $28.12 / $28.12	Professional	TC	$17.85	$28.12	$28.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.80 / $110.88 / $334.90	Facility		$62.80	$110.88	$334.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.82 / $37.15 / $65.34	Professional		$9.82	$37.15	$65.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.27 / $71.70 / $195.82	Facility		$35.27	$71.70	$195.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.51 / $42.03 / $60.45	Professional		$25.51	$42.03	$60.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $10.99 / $16.92	Professional	26	$6.80	$10.99	$16.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $31.33 / $45.77	Professional	TC	$19.13	$31.33	$45.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $53.80 / $164.90	Professional		$37.08	$53.80	$164.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $13.35 / $60.49	Professional	26	$9.42	$13.35	$60.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.76 / $39.04 / $104.69	Professional	TC	$26.76	$39.04	$104.69
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 $37.79 / $38.39 / $42.03	Professional		$37.79	$38.39	$42.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $9.61 / $10.21	Professional	26	$9.27	$9.61	$10.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.20 / $29.12 / $31.82	Professional	TC	$28.20	$29.12	$31.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.68 / $32.34 / $43.97	Professional		$10.68	$32.34	$43.97
United Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $38.35 / $58.85	Professional		$29.41	$38.35	$58.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $10.51 / $16.10	Professional	26	$8.23	$10.51	$16.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $27.98 / $43.52	Professional	TC	$20.91	$27.98	$43.52