Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.10 / $681.29 / $917.61	Facility		$179.10	$681.29	$917.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.46 / $38.17 / $41.69	Facility	26	$22.46	$38.17	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.56 / $138.13 / $533.42	Professional		$101.56	$138.13	$533.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $27.33 / $85.57	Professional	26	$18.48	$27.33	$85.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $111.67 / $206.11	Professional	TC	$95.53	$111.67	$206.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $105.11 / $169.58	Professional		$91.54	$105.11	$169.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.46 / $18.98 / $30.39	Professional	26	$16.46	$18.98	$30.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.97 / $565.76 / $2,037.92	Facility		$168.97	$565.76	$2,037.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $83.37 / $249.70	Professional		$25.73	$83.37	$249.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.43 / $327.37 / $916.00	Facility		$205.43	$327.37	$916.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.81 / $196.83 / $308.29	Professional		$137.81	$196.83	$308.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $30.86 / $44.12	Professional	26	$21.08	$30.86	$44.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.73 / $167.20 / $263.47	Professional	TC	$117.73	$167.20	$263.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $215.39 / $563.32	Professional		$146.72	$215.39	$563.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.52 / $34.88 / $127.69	Professional	26	$25.52	$34.88	$127.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.40 / $179.15 / $447.00	Professional	TC	$125.40	$179.15	$447.00
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 $166.22 / $170.09 / $185.42	Professional		$166.22	$170.09	$185.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.82 / $28.34 / $30.16	Professional	26	$26.82	$28.34	$30.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $137.88 / $143.27 / $155.26	Professional	TC	$137.88	$143.27	$155.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $32.34 / $180.92	Professional		$31.55	$32.34	$180.92
United Facility/Professional Professional Modifier Low / Median / High Price $149.76 / $217.56 / $329.52	Professional		$149.76	$217.56	$329.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $28.35 / $51.35	Professional	26	$21.51	$28.35	$51.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.05 / $190.10 / $306.64	Professional	TC	$127.05	$190.10	$306.64