Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $40.90 / $145.78	Facility		$20.53	$40.90	$145.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.84 / $5.01 / $5.01	Facility	26	$2.84	$5.01	$5.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $30.06 / $61.75	Professional		$18.60	$30.06	$61.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.44 / $3.91 / $7.87	Professional	26	$2.44	$3.91	$7.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.69 / $11.21 / $15.52	Professional	52	$8.69	$11.21	$15.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.11 / $25.10 / $37.97	Professional	TC	$15.11	$25.10	$37.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.55 / $27.72 / $27.72	Professional		$19.55	$27.72	$27.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.30 / $130.68 / $404.79	Facility		$60.30	$130.68	$404.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $19.61 / $34.28	Professional		$3.63	$19.61	$34.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.76 / $35.18 / $58.09	Professional		$20.76	$35.18	$58.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.90 / $5.01 / $12.55	Professional	26	$2.90	$5.01	$12.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.88 / $30.04 / $43.92	Professional	TC	$17.88	$30.04	$43.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.80 / $38.96 / $75.41	Professional		$25.80	$38.96	$75.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.60 / $5.46 / $26.55	Professional	26	$3.60	$5.46	$26.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $30.27 / $53.09	Professional	TC	$19.64	$30.27	$53.09
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 $27.04 / $27.33 / $30.49	Professional		$27.04	$27.33	$30.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.45 / $3.84 / $4.25	Professional	26	$3.45	$3.84	$4.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $23.88 / $26.23	Professional	TC	$23.21	$23.88	$26.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.45 / $31.89 / $32.34	Professional		$4.45	$31.89	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $33.15 / $59.66	Professional		$20.72	$33.15	$59.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.15 / $4.88 / $12.89	Professional	26	$3.15	$4.88	$12.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $26.59 / $44.93	Professional	TC	$18.14	$26.59	$44.93