Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $257.04 / $812.83	Facility		$39.81	$257.04	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $21.38 / $40.74	Facility	26	$13.18	$21.38	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $40.74 / $97.72	Professional		$28.84	$40.74	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.89 / $66.07	Professional	26	$12.02	$20.89	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $47.86	Professional	TC	$17.78	$25.12	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.20 / $63.10	Professional		$26.92	$30.20	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $22.91	Professional	26	$10.00	$13.80	$22.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $141.25 / $354.81	Facility		$83.18	$141.25	$354.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $41.69 / $87.10	Professional		$17.38	$41.69	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $74.13	Professional		$30.20	$46.77	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.05 / $29.51	Professional	26	$12.02	$19.05	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $46.77	Professional	TC	$18.20	$28.84	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $79.43 / $204.17	Professional		$42.66	$79.43	$204.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $27.54 / $162.18	Professional	26	$15.14	$27.54	$162.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $213.80	Professional	TC	$23.99	$36.31	$213.80
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 Professional Modifier Low / Median / High Price $45.71 / $45.71 / $50.12	Professional		$45.71	$45.71	$50.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $17.78	Professional	26	$16.22	$16.98	$17.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $30.20 / $32.36	Professional	TC	$28.84	$30.20	$32.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $16.22 / $33.11	Professional		$9.55	$16.22	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $23.99 / $38.02	Facility		$16.98	$23.99	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $63.10	Professional		$32.36	$42.66	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $17.38 / $26.30	Professional	26	$13.80	$17.38	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $38.02	Professional	TC	$18.20	$25.70	$38.02