Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.32 / $18.64 / $22.43	Facility	26	$11.32	$18.64	$22.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $46.85 / $95.67	Professional		$38.77	$46.85	$95.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $12.47 / $25.12	Professional	26	$10.91	$12.47	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $33.04 / $59.42	Professional	TC	$27.55	$33.04	$59.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $44.28 / $47.22	Professional		$27.68	$44.28	$47.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $16.44 / $17.61	Professional	26	$9.24	$16.44	$17.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.56 / $54.09 / $103.69	Professional		$15.56	$54.09	$103.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $60.89 / $87.58	Professional		$37.65	$60.89	$87.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.98 / $26.33	Professional	26	$10.51	$16.98	$26.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.24 / $44.04 / $64.34	Professional	TC	$27.24	$44.04	$64.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.03 / $76.23 / $201.40	Professional		$53.03	$76.23	$201.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.06 / $21.26 / $78.16	Professional	26	$15.06	$21.26	$78.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.85 / $55.06 / $123.24	Professional	TC	$37.85	$55.06	$123.24
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 $55.04 / $56.28 / $60.89	Professional		$55.04	$56.28	$60.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $15.35 / $16.16	Professional	26	$15.09	$15.35	$16.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $41.18 / $44.73	Professional	TC	$39.70	$41.18	$44.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $32.34 / $63.70	Professional		$16.89	$32.34	$63.70
United Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $56.38 / $87.24	Professional		$42.20	$56.38	$87.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $16.14 / $25.58	Professional	26	$12.92	$16.14	$25.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.26 / $39.59 / $60.63	Professional	TC	$29.26	$39.59	$60.63