Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.56 / $17.39 / $26.72	Facility	26	$11.56	$17.39	$26.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $67.63 / $163.40	Professional		$45.46	$67.63	$163.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $17.64 / $69.34	Professional	26	$11.92	$17.64	$69.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $39.93 / $77.11	Professional	TC	$33.39	$39.93	$77.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $42.35 / $54.82	Professional		$36.09	$42.35	$54.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $11.07 / $17.67	Professional	26	$9.61	$11.07	$17.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.90 / $48.44 / $55.38	Professional	TC	$34.90	$48.44	$55.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.38 / $62.42 / $109.80	Professional		$16.38	$62.42	$109.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $69.95 / $102.94	Professional		$42.79	$69.95	$102.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $18.64 / $29.52	Professional	26	$11.72	$18.64	$29.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $50.77 / $76.70	Professional	TC	$31.86	$50.77	$76.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $91.60 / $255.39	Professional		$62.05	$91.60	$255.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $21.80 / $93.49	Professional	26	$15.16	$21.80	$93.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.12 / $63.43 / $167.72	Professional	TC	$45.12	$63.43	$167.72
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 $63.52 / $65.16 / $70.34	Professional		$63.52	$65.16	$70.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $16.16 / $17.02	Professional	26	$15.93	$16.16	$17.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.37 / $49.23 / $53.33	Professional	TC	$47.37	$49.23	$53.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $32.34 / $73.59	Professional		$17.80	$32.34	$73.59
United Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $64.31 / $94.28	Professional		$48.69	$64.31	$94.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.05 / $19.87 / $40.74	Professional	26	$14.05	$19.87	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $46.44 / $69.72	Professional	TC	$34.15	$46.44	$69.72