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 / $41.69	Facility	26	$12.02	$23.99	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $50.12 / $162.18	Professional		$34.67	$50.12	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.50 / $45.71	Professional	26	$10.96	$19.50	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $63.10	Professional	TC	$22.91	$31.62	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $70.79	Professional		$28.18	$33.11	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.38 / $21.38	Professional	26	$10.23	$17.38	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	TC	$19.95	$19.95	$19.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $44.67 / $97.72	Professional		$17.38	$44.67	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $81.28	Professional		$35.48	$54.95	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.20 / $27.54	Professional	26	$11.75	$18.20	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $56.23	Professional	TC	$23.99	$38.02	$56.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $100.00 / $251.19	Professional		$52.48	$100.00	$251.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $27.54 / $104.71	Professional	26	$16.60	$27.54	$104.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $47.86 / $147.91	Professional	TC	$33.88	$47.86	$147.91
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 $51.29 / $52.48 / $57.54	Professional		$51.29	$52.48	$57.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.98 / $17.78	Professional	26	$16.60	$16.98	$17.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $38.90	Professional	TC	$34.67	$36.31	$38.90
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 $38.90 / $50.12 / $75.86	Professional		$38.90	$50.12	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.60 / $26.92	Professional	26	$13.18	$16.60	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $50.12	Professional	TC	$25.70	$33.88	$50.12