Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $302.00 / $549.54	Facility		$60.26	$302.00	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.47 / $25.70	Facility	26	$7.41	$10.47	$25.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $83.18 / $457.09	Facility	TC	$27.54	$83.18	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $40.74 / $134.90	Professional		$8.91	$40.74	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.14 / $50.12	Professional	26	$7.94	$15.14	$50.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $91.20 / $288.40	Professional	50	$30.90	$91.20	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.79 / $29.51 / $97.72	Professional	52	$14.79	$29.51	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $85.11	Professional	TC	$22.91	$39.81	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.18 / $45.71	Professional		$22.91	$28.18	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.76 / $13.18	Professional	26	$6.17	$7.76	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $41.69 / $47.86	Professional	50	$30.20	$41.69	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $45.71	Professional	TC	$17.78	$26.30	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $117.49 / $338.84	Facility		$61.66	$117.49	$338.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $41.69 / $75.86	Professional		$10.72	$41.69	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $54.95 / $134.90	Facility		$26.92	$54.95	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $66.07	Professional		$28.84	$43.65	$66.07
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 $20.89 / $32.36 / $52.48	Professional	TC	$20.89	$32.36	$52.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $72.44 / $186.21	Professional		$39.81	$72.44	$186.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.79 / $69.18	Professional	26	$9.77	$14.79	$69.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $42.66 / $123.03	Professional	TC	$27.54	$42.66	$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 $42.66 / $43.65 / $47.86	Professional		$42.66	$43.65	$47.86
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 $32.36 / $33.88 / $36.31	Professional	TC	$32.36	$33.88	$36.31
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 $20.42 / $74.13 / $229.09	Facility		$20.42	$74.13	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $60.26	Professional		$30.20	$39.81	$60.26
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 $21.88 / $29.51 / $45.71	Professional	TC	$21.88	$29.51	$45.71