Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $26.30 / $46.77	Facility	26	$14.13	$26.30	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $239.88	Professional		$43.65	$66.07	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.99 / $54.95	Professional	26	$12.88	$23.99	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $81.28	Professional	TC	$28.84	$40.74	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.88 / $47.86	Professional		$32.36	$33.88	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.45 / $22.91	Professional	26	$11.48	$14.45	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $40.74	Professional	TC	$22.91	$22.91	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $52.48 / $117.49	Professional		$19.50	$52.48	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $97.72	Professional		$42.66	$67.61	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $21.38 / $30.90	Professional	26	$13.18	$21.38	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $46.77 / $72.44	Professional	TC	$30.20	$46.77	$72.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $117.49 / $251.19	Professional		$61.66	$117.49	$251.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $31.62 / $100.00	Professional	26	$18.62	$31.62	$100.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $64.57 / $173.78	Professional	TC	$40.74	$64.57	$173.78
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 $61.66 / $63.10 / $69.18	Professional		$61.66	$63.10	$69.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.05 / $20.42	Professional	26	$18.62	$19.05	$20.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $44.67 / $47.86	Professional	TC	$42.66	$44.67	$47.86
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 $46.77 / $60.26 / $91.20	Professional		$46.77	$60.26	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.05 / $30.20	Professional	26	$15.14	$19.05	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $61.66	Professional	TC	$31.62	$42.66	$61.66