Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $17.38 / $30.20	Facility	26	$8.91	$17.38	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $158.49	Professional		$28.84	$47.86	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.45 / $38.02	Professional	26	$7.94	$14.45	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $51.29	Professional	TC	$19.05	$26.30	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $48.98	Professional		$21.38	$27.54	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.76 / $15.85	Professional	26	$7.41	$7.76	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.38 / $18.62	Professional	TC	$17.38	$17.38	$18.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $40.74 / $70.79	Professional		$12.59	$40.74	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $67.61	Professional		$28.84	$46.77	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $22.39	Professional	26	$8.91	$14.13	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $47.86	Professional	TC	$19.95	$31.62	$47.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $204.17	Professional		$41.69	$87.10	$204.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.89 / $77.62	Professional	26	$12.30	$20.89	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $43.65 / $147.91	Professional	TC	$28.84	$43.65	$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 $40.74 / $41.69 / $45.71	Professional		$40.74	$41.69	$45.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.59 / $13.18	Professional	26	$12.30	$12.59	$13.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $29.51 / $32.36	Professional	TC	$28.84	$29.51	$32.36
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 $32.36 / $41.69 / $61.66	Professional		$32.36	$41.69	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.18 / $20.42	Professional	26	$10.47	$13.18	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $41.69	Professional	TC	$21.38	$28.18	$41.69