Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.11 / $17.63 / $21.28	Facility	26	$11.11	$17.63	$21.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $42.48 / $78.77	Professional		$35.67	$42.48	$78.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $11.91 / $25.13	Professional	26	$10.29	$11.91	$25.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $30.21 / $54.63	Professional	TC	$25.05	$30.21	$54.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $32.53 / $44.14	Professional		$25.92	$32.53	$44.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $11.23 / $15.71	Professional	26	$8.67	$11.23	$15.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $50.66 / $97.12	Professional		$15.15	$50.66	$97.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $53.93 / $82.02	Professional		$34.72	$53.93	$82.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $16.34 / $25.61	Professional	26	$10.02	$16.34	$25.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $38.11 / $59.39	Professional	TC	$24.57	$38.11	$59.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $70.29 / $165.15	Professional		$48.25	$70.29	$165.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.64 / $20.66 / $60.07	Professional	26	$14.64	$20.66	$60.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.82 / $50.17 / $105.59	Professional	TC	$33.82	$50.17	$105.59
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 $51.56 / $52.64 / $57.02	Professional		$51.56	$52.64	$57.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.68 / $14.92 / $15.74	Professional	26	$14.68	$14.92	$15.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.63 / $37.97 / $41.29	Professional	TC	$36.63	$37.97	$41.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.47 / $32.34 / $59.65	Professional		$16.47	$32.34	$59.65
United Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $51.54 / $78.84	Professional		$39.15	$51.54	$78.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $16.93 / $32.31	Professional	26	$12.62	$16.93	$32.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.33 / $34.54 / $55.32	Professional	TC	$26.33	$34.54	$55.32