Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.68 / $22.04 / $24.18	Facility	26	$12.68	$22.04	$24.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $47.62 / $85.23	Professional		$39.42	$47.62	$85.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $13.48 / $26.38	Professional	26	$11.73	$13.48	$26.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $33.04 / $59.54	Professional	TC	$27.87	$33.04	$59.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $31.05 / $35.49	Professional		$31.05	$31.05	$35.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $13.15 / $19.02	Professional	26	$10.18	$13.15	$19.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $55.29 / $106.00	Professional		$16.79	$55.29	$106.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $62.16 / $89.42	Professional		$38.35	$62.16	$89.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.36 / $18.26 / $28.47	Professional	26	$11.36	$18.26	$28.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.28 / $44.04 / $64.34	Professional	TC	$27.28	$44.04	$64.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.46 / $79.08 / $195.36	Professional		$54.46	$79.08	$195.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $22.95 / $74.48	Professional	26	$16.26	$22.95	$74.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.85 / $55.06 / $122.29	Professional	TC	$37.85	$55.06	$122.29
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 $56.28 / $57.53 / $62.17	Professional		$56.28	$57.53	$62.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $16.57 / $17.43	Professional	26	$16.34	$16.57	$17.43
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 $18.23 / $32.34 / $65.04	Professional		$18.23	$32.34	$65.04
United Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $56.61 / $87.01	Professional		$43.95	$56.61	$87.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $17.32 / $26.89	Professional	26	$13.72	$17.32	$26.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.43 / $39.65 / $60.98	Professional	TC	$29.43	$39.65	$60.98