Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $245.47 / $407.38	Facility		$39.81	$245.47	$407.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $11.22 / $26.92	Facility	26	$7.76	$11.22	$26.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $36.31 / $363.08	Facility	TC	$19.95	$36.31	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $43.65 / $128.82	Professional		$25.12	$43.65	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $41.69	Professional	26	$7.94	$12.02	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.30 / $57.54	Professional	TC	$16.98	$26.30	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $28.18	Professional		$18.20	$21.88	$28.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.13 / $12.59	Professional	26	$6.46	$8.13	$12.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $19.50 / $28.84	Professional	TC	$13.80	$19.50	$28.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $112.20 / $257.04	Facility		$56.23	$112.20	$257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $34.67 / $67.61	Professional		$10.96	$34.67	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $58.88 / $131.83	Facility		$20.89	$58.88	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $54.95	Professional		$23.99	$36.31	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $17.78	Professional	26	$7.41	$12.02	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $25.12 / $38.90	Professional	TC	$16.60	$25.12	$38.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $75.86 / $194.98	Professional		$35.48	$75.86	$194.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $27.54 / $79.43	Professional	26	$10.47	$27.54	$79.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $34.67 / $147.91	Professional	TC	$20.89	$34.67	$147.91
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 $35.48 / $36.31 / $39.81	Professional		$35.48	$36.31	$39.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.72 / $11.48	Professional	26	$10.47	$10.72	$11.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $25.70 / $28.18	Professional	TC	$24.55	$25.70	$28.18
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 $18.20 / $74.13 / $229.09	Facility		$18.20	$74.13	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $50.12	Professional		$26.30	$33.88	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.96 / $16.60	Professional	26	$8.91	$10.96	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.44 / $34.67	Professional	TC	$17.38	$23.44	$34.67