Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.59 / $13.63 / $17.67	Facility	26	$8.59	$13.63	$17.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $32.40 / $52.34	Professional		$25.05	$32.40	$52.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.58 / $17.82	Professional	26	$8.13	$9.58	$17.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $21.70 / $34.40	Professional	TC	$17.67	$21.70	$34.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $19.14 / $19.14	Professional		$19.14	$19.14	$19.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $12.78 / $13.77	Professional	26	$7.36	$12.78	$13.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.29 / $32.08 / $71.42	Professional		$12.29	$32.08	$71.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $43.44 / $60.99	Professional		$26.01	$43.44	$60.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $13.26 / $20.64	Professional	26	$8.22	$13.26	$20.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $29.44 / $43.44	Professional	TC	$17.84	$29.44	$43.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.93 / $167.16	Professional		$37.15	$54.93	$167.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $16.68 / $67.28	Professional	26	$11.78	$16.68	$67.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.90 / $36.85 / $108.90	Professional	TC	$24.90	$36.85	$108.90
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 $37.90 / $38.45 / $42.00	Professional		$37.90	$38.45	$42.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.03 / $12.77	Professional	26	$11.75	$12.03	$12.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $26.70 / $29.24	Professional	TC	$25.90	$26.70	$29.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.36 / $32.34 / $43.94	Professional		$13.36	$32.34	$43.94
United Facility/Professional Professional Modifier Low / Median / High Price $29.98 / $38.35 / $59.84	Professional		$29.98	$38.35	$59.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $12.31 / $19.55	Professional	26	$9.71	$12.31	$19.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.96 / $26.49 / $40.17	Professional	TC	$19.96	$26.49	$40.17