Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.15 / $23.15 / $27.87	Facility	26	$14.15	$23.15	$27.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $53.00 / $107.23	Professional		$44.64	$53.00	$107.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $15.21 / $37.17	Professional	26	$13.55	$15.21	$37.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $38.60 / $69.54	Professional	TC	$30.92	$38.60	$69.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $47.21 / $50.96	Professional		$33.97	$47.21	$50.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.65 / $18.84	Professional	26	$11.22	$14.65	$18.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $50.76 / $50.76	Professional	TC	$50.76	$50.76	$50.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $60.91 / $116.76	Professional		$19.64	$60.91	$116.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $70.34 / $102.37	Professional		$42.65	$70.34	$102.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.04 / $21.19 / $32.74	Professional	26	$13.04	$21.19	$32.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $48.17 / $72.42	Professional	TC	$30.32	$48.17	$72.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.79 / $89.68 / $221.54	Professional		$60.79	$89.68	$221.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.84 / $26.61 / $90.22	Professional	26	$18.84	$26.61	$90.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.13 / $59.78 / $127.21	Professional	TC	$41.13	$59.78	$127.21
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 $61.98 / $62.97 / $68.58	Professional		$61.98	$62.97	$68.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $19.21 / $20.41	Professional	26	$18.55	$19.21	$20.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.77 / $44.41 / $48.17	Professional	TC	$42.77	$44.41	$48.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $32.34 / $71.73	Professional		$21.35	$32.34	$71.73
United Facility/Professional Professional Modifier Low / Median / High Price $49.32 / $65.20 / $96.86	Professional		$49.32	$65.20	$96.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $19.92 / $30.93	Professional	26	$15.77	$19.92	$30.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $45.30 / $65.23	Professional	TC	$32.33	$45.30	$65.23