Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $16.98 / $37.15	Facility	26	$10.96	$16.98	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $169.82	Professional		$38.02	$60.26	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.78 / $43.65	Professional	26	$10.00	$17.78	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $77.62	Professional	TC	$25.70	$36.31	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $44.67	Professional		$30.20	$34.67	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.47 / $15.49	Professional	26	$9.33	$10.47	$15.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $25.12	Professional	TC	$20.42	$25.12	$25.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $53.70 / $104.71	Professional		$15.49	$53.70	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $57.54 / $85.11	Professional		$37.15	$57.54	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.98 / $25.70	Professional	26	$10.72	$16.98	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.69 / $64.57	Professional	TC	$27.54	$41.69	$64.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $218.78	Professional		$52.48	$104.71	$218.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $25.70 / $87.10	Professional	26	$14.79	$25.70	$87.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $61.66 / $141.25	Professional	TC	$38.02	$61.66	$141.25
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 $54.95 / $56.23 / $60.26	Professional		$54.95	$56.23	$60.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.49 / $16.22	Professional	26	$15.14	$15.49	$16.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $40.74 / $44.67	Professional	TC	$39.81	$40.74	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $79.43	Professional		$40.74	$53.70	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.49 / $23.99	Professional	26	$12.30	$15.49	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $56.23	Professional	TC	$28.18	$38.02	$56.23