Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.92 / $273.08 / $791.19	Facility		$41.92	$273.08	$791.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.19 / $21.14 / $25.08	Facility	26	$13.19	$21.14	$25.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $38.07 / $68.62	Professional		$30.91	$38.07	$68.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $15.24 / $55.54	Professional	26	$12.75	$15.24	$55.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $23.94 / $43.24	Professional	TC	$17.89	$23.94	$43.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.65 / $27.29 / $37.54	Professional		$23.65	$27.29	$37.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $14.41 / $18.52	Professional	26	$9.92	$14.41	$18.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.21 / $142.57 / $379.03	Facility		$83.21	$142.57	$379.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.18 / $45.01 / $86.28	Professional		$17.18	$45.01	$86.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.28 / $36.28 / $36.28	Facility		$36.28	$36.28	$36.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.38 / $51.07 / $69.18	Professional		$31.38	$51.07	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $19.23 / $28.67	Professional	26	$12.28	$19.23	$28.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $30.70 / $45.25	Professional	TC	$18.66	$30.70	$45.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $61.11 / $140.66	Professional		$42.75	$61.11	$140.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $21.95 / $97.60	Professional	26	$15.16	$21.95	$97.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $35.65 / $96.25	Professional	TC	$23.89	$35.65	$96.25
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 $45.80 / $46.03 / $50.52	Professional		$45.80	$46.03	$50.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $16.85 / $17.84	Professional	26	$16.11	$16.85	$17.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $29.91 / $32.68	Professional	TC	$28.96	$29.91	$32.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.50 / $18.69 / $37.71	Professional		$9.50	$18.69	$37.71
United Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $44.34 / $65.58	Professional		$33.08	$44.34	$65.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $18.80 / $27.58	Professional	26	$14.39	$18.80	$27.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $26.27 / $41.00	Professional	TC	$18.60	$26.27	$41.00