Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $16.22 / $38.02	Facility	26	$10.96	$16.22	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $223.87	Professional		$44.67	$75.86	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $21.38 / $63.10	Professional	26	$11.75	$21.38	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $93.33	Professional	TC	$32.36	$48.98	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $66.07	Professional		$31.62	$39.81	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.22 / $19.05	Professional	26	$9.55	$11.22	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $56.23	Professional	TC	$26.92	$38.02	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $60.26 / $104.71	Professional		$15.85	$60.26	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $100.00	Professional		$41.69	$67.61	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $18.62 / $29.51	Professional	26	$11.22	$18.62	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $48.98 / $74.13	Professional	TC	$31.62	$48.98	$74.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $295.12	Professional		$61.66	$107.15	$295.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $22.91 / $107.15	Professional	26	$15.14	$22.91	$107.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $61.66 / $194.98	Professional	TC	$43.65	$61.66	$194.98
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 / $67.61	Professional		$61.66	$63.10	$67.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.85 / $16.60	Professional	26	$15.49	$15.85	$16.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $46.77 / $51.29	Professional	TC	$45.71	$46.77	$51.29
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 / $87.10	Professional		$46.77	$60.26	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $17.38 / $25.70	Professional	26	$12.59	$17.38	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $42.66 / $63.10	Professional	TC	$32.36	$42.66	$63.10