Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.28 / $16.98 / $23.21	Facility	26	$11.28	$16.98	$23.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $48.93 / $144.40	Professional		$31.35	$48.93	$144.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $14.77 / $39.84	Professional	26	$11.28	$14.77	$39.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $29.66 / $57.40	Professional	TC	$24.12	$29.66	$57.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $37.97 / $51.58	Professional		$28.21	$37.97	$51.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $10.78 / $17.23	Professional	26	$9.38	$10.78	$17.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $31.06 / $40.25	Professional	TC	$21.52	$31.06	$40.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $48.85 / $93.65	Professional		$15.96	$48.85	$93.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $54.86 / $78.91	Professional		$33.86	$54.86	$78.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $17.54 / $27.04	Professional	26	$10.80	$17.54	$27.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.34 / $37.57 / $55.06	Professional	TC	$23.34	$37.57	$55.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.98 / $70.65 / $183.28	Professional		$47.98	$70.65	$183.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $21.83 / $76.65	Professional	26	$15.47	$21.83	$76.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.38 / $46.88 / $107.86	Professional	TC	$32.38	$46.88	$107.86
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 $49.71 / $50.66 / $54.86	Professional		$49.71	$50.66	$54.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $15.77 / $16.59	Professional	26	$15.52	$15.77	$16.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $35.15 / $38.27	Professional	TC	$33.94	$35.15	$38.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $32.34 / $57.39	Professional		$17.35	$32.34	$57.39
United Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $50.74 / $76.47	Professional		$39.11	$50.74	$76.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $18.55 / $51.30	Professional	26	$13.35	$18.55	$51.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.32 / $33.35 / $52.26	Professional	TC	$25.32	$33.35	$52.26