Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.98 / $22.59 / $24.78	Facility	26	$12.98	$22.59	$24.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $44.19 / $92.39	Professional		$36.88	$44.19	$92.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.74 / $30.40	Professional	26	$11.50	$13.74	$30.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $28.95 / $51.90	Professional	TC	$25.14	$28.95	$51.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $41.47 / $43.84	Professional		$31.61	$41.47	$43.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $18.14 / $18.55	Professional	26	$10.25	$18.14	$18.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.19 / $45.17 / $97.40	Professional		$17.19	$45.17	$97.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $57.82 / $81.98	Professional		$35.22	$57.82	$81.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.53 / $18.55 / $29.10	Professional	26	$11.53	$18.55	$29.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $39.13 / $58.25	Professional	TC	$23.87	$39.13	$58.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $74.53 / $215.66	Professional		$50.42	$74.53	$215.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $23.53 / $98.59	Professional	26	$16.66	$23.53	$98.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.38 / $48.06 / $141.93	Professional	TC	$33.38	$48.06	$141.93
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 $51.70 / $52.72 / $56.99	Professional		$51.70	$52.72	$56.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.76 / $16.98 / $17.86	Professional	26	$16.76	$16.98	$17.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.71 / $35.96 / $39.13	Professional	TC	$34.71	$35.96	$39.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.69 / $32.34 / $59.62	Professional		$18.69	$32.34	$59.62
United Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $52.39 / $82.16	Professional		$40.31	$52.39	$82.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $17.84 / $28.19	Professional	26	$13.69	$17.84	$28.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $33.83 / $53.12	Professional	TC	$26.10	$33.83	$53.12