Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.22 / $15.62 / $21.28	Facility	26	$9.22	$15.62	$21.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $38.95 / $87.91	Professional		$31.89	$38.95	$87.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $11.23 / $22.23	Professional	26	$9.22	$11.23	$22.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $27.69 / $47.23	Professional	TC	$22.67	$27.69	$47.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $27.94 / $35.74	Professional		$22.48	$27.94	$35.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $8.82 / $13.31	Professional	26	$7.64	$8.82	$13.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.93 / $28.93 / $28.93	Professional	TC	$28.93	$28.93	$28.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $41.68 / $83.91	Professional		$13.10	$41.68	$83.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $51.19 / $76.90	Professional		$31.60	$51.19	$76.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $14.85 / $23.57	Professional	26	$9.35	$14.85	$23.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $36.51 / $52.98	Professional	TC	$22.41	$36.51	$52.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $64.45 / $167.16	Professional		$43.68	$64.45	$167.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $18.32 / $65.01	Professional	26	$12.61	$18.32	$65.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.97 / $45.03 / $105.61	Professional	TC	$30.97	$45.03	$105.61
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 $44.54 / $45.34 / $49.30	Professional		$44.54	$45.34	$49.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $12.90 / $13.61	Professional	26	$12.61	$12.90	$13.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $32.72 / $35.70	Professional	TC	$31.64	$32.72	$35.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.24 / $32.34 / $51.57	Professional		$14.24	$32.34	$51.57
United Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $47.71 / $69.84	Professional		$37.04	$47.71	$69.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $15.01 / $22.66	Professional	26	$11.35	$15.01	$22.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.43 / $32.75 / $48.23	Professional	TC	$24.43	$32.75	$48.23