Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.98 / $18.64 / $22.61	Facility	26	$10.98	$18.64	$22.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $42.56 / $82.07	Professional		$35.09	$42.56	$82.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $13.60 / $32.90	Professional	26	$10.98	$13.60	$32.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $28.82 / $52.92	Professional	TC	$23.26	$28.82	$52.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $40.82 / $43.40	Professional		$32.06	$40.82	$43.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.49 / $11.84 / $13.86	Professional	26	$10.49	$11.84	$13.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.56 / $43.01 / $87.86	Professional		$15.56	$43.01	$87.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $54.70 / $80.78	Professional		$34.03	$54.70	$80.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.89 / $26.90	Professional	26	$10.51	$16.89	$26.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $37.42 / $57.53	Professional	TC	$23.51	$37.42	$57.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.85 / $73.44 / $203.00	Professional		$49.85	$73.44	$203.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $21.26 / $77.75	Professional	26	$14.76	$21.26	$77.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.00 / $49.15 / $125.01	Professional	TC	$34.00	$49.15	$125.01
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 $50.83 / $51.86 / $56.16	Professional		$50.83	$51.86	$56.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $15.35 / $16.16	Professional	26	$15.09	$15.35	$16.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $36.76 / $40.00	Professional	TC	$35.47	$36.76	$40.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $32.34 / $58.75	Professional		$16.89	$32.34	$58.75
United Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $49.52 / $76.00	Professional		$38.00	$49.52	$76.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.34 / $16.45 / $25.47	Professional	26	$13.34	$16.45	$25.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.44 / $34.22 / $53.12	Professional	TC	$25.44	$34.22	$53.12