Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.43 / $990.76 / $1,735.19	Facility		$236.43	$990.76	$1,735.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.79 / $45.91 / $58.89	Facility	26	$32.79	$45.91	$58.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $161.41 / $273.69 / $1,322.24	Facility	TC	$161.41	$273.69	$1,322.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.50 / $230.69 / $541.01	Professional		$165.50	$230.69	$541.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $46.27 / $154.58	Professional	26	$31.89	$46.27	$154.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.91 / $169.96 / $306.48	Professional	TC	$134.91	$169.96	$306.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $141.68 / $206.64	Professional		$119.61	$141.68	$206.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.75 / $27.63 / $43.79	Professional	26	$23.75	$27.63	$43.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $115.21 / $183.42 / $208.92	Professional	TC	$115.21	$183.42	$208.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $307.19 / $738.14 / $2,602.71	Facility		$307.19	$738.14	$2,602.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $118.85 / $324.85	Professional		$36.61	$118.85	$324.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $258.33 / $448.34 / $916.00	Facility		$258.33	$448.34	$916.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.02 / $260.41 / $404.87	Professional		$179.02	$260.41	$404.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $45.56 / $68.93	Professional	26	$31.94	$45.56	$68.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.15 / $213.10 / $338.99	Professional	TC	$150.15	$213.10	$338.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $198.64 / $283.36 / $696.91	Professional		$198.64	$283.36	$696.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $50.46 / $231.26	Professional	26	$36.31	$50.46	$231.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.80 / $216.43 / $497.13	Professional	TC	$159.80	$216.43	$497.13
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 $216.24 / $221.70 / $240.76	Professional		$216.24	$221.70	$240.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $40.39 / $42.91	Professional	26	$38.58	$40.39	$42.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.85 / $183.12 / $197.85	Professional	TC	$175.85	$183.12	$197.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.89 / $251.87	Professional		$32.34	$44.89	$251.87
United Facility/Professional Professional Modifier Low / Median / High Price $197.91 / $279.07 / $423.52	Professional		$197.91	$279.07	$423.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.59 / $44.21 / $73.76	Professional	26	$32.59	$44.21	$73.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.94 / $238.67 / $376.40	Professional	TC	$161.94	$238.67	$376.40