Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $21.38 / $37.15	Facility	26	$10.96	$21.38	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $162.18	Professional		$34.67	$53.70	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.05 / $50.12	Professional	26	$10.96	$19.05	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $70.79	Professional	TC	$22.91	$32.36	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $61.66	Professional		$22.91	$29.51	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $19.05	Professional	26	$9.33	$13.49	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	TC	$28.84	$28.84	$28.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $42.66 / $87.10	Professional		$15.49	$42.66	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.48 / $79.43	Professional		$33.88	$52.48	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.38 / $26.30	Professional	26	$10.72	$17.38	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.48 / $54.95	Professional	TC	$23.44	$35.48	$54.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $120.23 / $239.88	Professional		$51.29	$120.23	$239.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $38.90 / $91.20	Professional	26	$14.79	$38.90	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $61.66 / $141.25	Professional	TC	$35.48	$61.66	$141.25
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 $51.29 / $51.29 / $56.23	Professional		$51.29	$51.29	$56.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.49 / $16.22	Professional	26	$15.14	$15.49	$16.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $37.15 / $39.81	Professional	TC	$35.48	$37.15	$39.81
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 $37.15 / $47.86 / $72.44	Professional		$37.15	$47.86	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $25.12	Professional	26	$12.88	$16.22	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $48.98	Professional	TC	$23.99	$32.36	$48.98