Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.64 / $235.42 / $856.38	Facility		$101.64	$235.42	$856.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.78 / $39.63 / $53.65	Facility	26	$22.78	$39.63	$53.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.97 / $126.06 / $239.39	Professional		$102.97	$126.06	$239.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $23.93 / $39.63	Professional	26	$20.50	$23.93	$39.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $104.97 / $151.41	Professional	TC	$86.20	$104.97	$151.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.22 / $121.22 / $121.22	Professional		$121.22	$121.22	$121.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.46 / $546.21 / $1,860.42	Facility		$178.46	$546.21	$1,860.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.82 / $86.21 / $205.92	Professional		$26.82	$86.21	$205.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.44 / $289.64 / $876.36	Facility		$151.44	$289.64	$876.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.95 / $165.89 / $257.20	Professional		$114.95	$165.89	$257.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $32.65 / $45.89	Professional	26	$22.67	$32.65	$45.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.02 / $132.65 / $222.79	Professional	TC	$92.02	$132.65	$222.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.53 / $180.29 / $443.70	Professional		$126.53	$180.29	$443.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.49 / $36.27 / $122.15	Professional	26	$26.49	$36.27	$122.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.63 / $142.75 / $321.55	Professional	TC	$102.63	$142.75	$321.55
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 $137.07 / $139.50 / $152.72	Professional		$137.07	$139.50	$152.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $29.30 / $31.43	Professional	26	$27.35	$29.30	$31.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.77 / $112.15 / $121.29	Professional	TC	$107.77	$112.15	$121.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $159.77	Professional		$32.34	$32.34	$159.77
United Facility/Professional Facility Modifier Low / Median / High Price $23.90 / $112.53 / $180.78	Facility		$23.90	$112.53	$180.78
United Facility/Professional Professional Modifier Low / Median / High Price $120.63 / $177.17 / $276.74	Professional		$120.63	$177.17	$276.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $30.88 / $53.72	Professional	26	$22.74	$30.88	$53.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.69 / $147.26 / $247.61	Professional	TC	$96.69	$147.26	$247.61