Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $23.99 / $39.81	Facility	26	$12.02	$23.99	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $162.18	Professional		$38.02	$51.29	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $45.71	Professional	26	$10.96	$16.98	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $34.67 / $69.18	Professional	TC	$25.70	$34.67	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.59 / $16.22	Professional	26	$10.00	$12.59	$16.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $54.95 / $107.15	Professional		$16.98	$54.95	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $87.10	Professional		$38.02	$60.26	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.62 / $27.54	Professional	26	$11.48	$18.62	$27.54
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 $54.95 / $107.15 / $223.87	Professional		$54.95	$107.15	$223.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.54 / $83.18	Professional	26	$16.22	$27.54	$83.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $57.54 / $154.88	Professional	TC	$38.02	$57.54	$154.88
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 $56.23 / $57.54 / $61.66	Professional		$56.23	$57.54	$61.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.60 / $17.38	Professional	26	$16.22	$16.60	$17.38
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 $41.69 / $53.70 / $81.28	Professional		$41.69	$53.70	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.60 / $25.70	Professional	26	$12.88	$16.60	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $56.23	Professional	TC	$28.18	$38.02	$56.23