Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $288.40 / $524.81	Facility		$46.77	$288.40	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $11.22 / $25.70	Facility	26	$7.41	$11.22	$25.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $43.65 / $407.38	Facility	TC	$22.91	$43.65	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $36.31 / $134.90	Professional		$10.47	$36.31	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.45 / $43.65	Professional	26	$7.76	$14.45	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.55 / $79.43 / $239.88	Professional	50	$24.55	$79.43	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $81.28	Professional	TC	$19.95	$35.48	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $40.74	Professional		$21.38	$25.12	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.76 / $12.30	Professional	26	$6.17	$7.76	$12.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $36.31 / $60.26	Professional	50	$30.20	$36.31	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $22.91 / $33.11	Professional	TC	$14.79	$22.91	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $125.89 / $316.23	Facility		$70.79	$125.89	$316.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $38.02 / $66.07	Professional		$10.72	$38.02	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $52.48 / $120.23	Facility		$23.44	$52.48	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $63.10	Professional		$26.92	$42.66	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $16.98	Professional	26	$7.08	$11.48	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $47.86	Professional	TC	$20.42	$31.62	$47.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $74.13 / $190.55	Professional		$38.02	$74.13	$190.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $79.43	Professional	26	$10.00	$17.38	$79.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $123.03	Professional	TC	$26.92	$38.90	$123.03
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 $38.90 / $38.90 / $42.66	Professional		$38.90	$38.90	$42.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.47 / $10.96	Professional	26	$10.00	$10.47	$10.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.84 / $31.62	Professional	TC	$28.18	$28.84	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $74.13 / $229.09	Facility		$22.39	$74.13	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $56.23	Professional		$29.51	$38.02	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $15.85	Professional	26	$8.13	$10.47	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $39.81	Professional	TC	$20.89	$28.18	$39.81