Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.81 / $18.80 / $20.67	Facility	26	$10.81	$18.80	$20.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $52.79 / $96.56	Professional		$43.78	$52.79	$96.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.29 / $23.83	Professional	26	$10.02	$11.29	$23.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $39.65 / $71.69	Professional	TC	$33.15	$39.65	$71.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $38.26 / $38.26	Professional		$31.46	$38.26	$38.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $8.19 / $12.02	Professional	26	$8.19	$8.19	$12.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.33 / $51.42 / $117.28	Professional		$14.33	$51.42	$117.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $66.42 / $99.36	Professional		$41.85	$66.42	$99.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $16.03 / $24.24	Professional	26	$9.66	$16.03	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $50.02 / $77.95	Professional	TC	$32.47	$50.02	$77.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.44 / $85.01 / $261.55	Professional		$58.44	$85.01	$261.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.85 / $19.55 / $69.68	Professional	26	$13.85	$19.55	$69.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.78 / $66.65 / $196.76	Professional	TC	$45.78	$66.65	$196.76
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 $62.26 / $63.90 / $69.06	Professional		$62.26	$63.90	$69.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $14.12 / $14.89	Professional	26	$13.86	$14.12	$14.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.14 / $50.04 / $54.18	Professional	TC	$48.14	$50.04	$54.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.57 / $32.34 / $72.26	Professional		$15.57	$32.34	$72.26
United Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $61.68 / $101.31	Professional		$47.42	$61.68	$101.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $15.16 / $23.38	Professional	26	$12.07	$15.16	$23.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.72 / $47.61 / $76.93	Professional	TC	$34.72	$47.61	$76.93