Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $16.98 / $38.02	Facility	26	$11.22	$16.98	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $47.86 / $158.49	Professional		$19.50	$47.86	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.05 / $48.98	Professional	26	$10.96	$19.05	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $74.13	Professional	TC	$23.99	$37.15	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $38.90	Professional		$25.70	$30.20	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.02 / $19.50	Professional	26	$9.55	$12.02	$19.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $38.02	Professional	TC	$21.88	$31.62	$38.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $48.98 / $93.33	Professional		$15.85	$48.98	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.48 / $77.62	Professional		$33.88	$52.48	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $26.30	Professional	26	$10.96	$17.78	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.48 / $54.95	Professional	TC	$23.44	$35.48	$54.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $97.72 / $302.00	Professional		$47.86	$97.72	$302.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $26.30 / $114.82	Professional	26	$15.14	$26.30	$114.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $120.23	Professional	TC	$32.36	$50.12	$120.23
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 $50.12 / $50.12 / $54.95	Professional		$50.12	$50.12	$54.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.85 / $16.60	Professional	26	$15.49	$15.85	$16.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $35.48 / $38.02	Professional	TC	$33.88	$35.48	$38.02
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 $37.15 / $47.86 / $72.44	Professional		$37.15	$47.86	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.85 / $25.12	Professional	26	$12.59	$15.85	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $47.86	Professional	TC	$23.99	$32.36	$47.86