Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.98 / $16.46 / $26.72	Facility	26	$10.98	$16.46	$26.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.42 / $65.16 / $159.26	Professional		$45.42	$65.16	$159.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $17.61 / $65.59	Professional	26	$11.20	$17.61	$65.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $41.42 / $73.95	Professional	TC	$32.29	$41.42	$73.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $46.90 / $52.79	Professional		$36.79	$46.90	$52.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $10.80 / $17.23	Professional	26	$9.14	$10.80	$17.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.49 / $46.48 / $53.15	Professional	TC	$33.49	$46.48	$53.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.97 / $60.12 / $105.66	Professional		$15.97	$60.12	$105.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $69.88 / $101.34	Professional		$42.30	$69.88	$101.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $18.34 / $29.48	Professional	26	$11.42	$18.34	$29.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.21 / $50.71 / $75.81	Professional	TC	$31.21	$50.71	$75.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $88.62 / $263.50	Professional		$60.00	$88.62	$263.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $21.62 / $93.51	Professional	26	$14.76	$21.62	$93.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.31 / $60.24 / $188.65	Professional	TC	$43.31	$60.24	$188.65
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 $61.18 / $62.73 / $67.77	Professional		$61.18	$62.73	$67.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $15.73 / $16.59	Professional	26	$15.50	$15.73	$16.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.45 / $47.23 / $51.18	Professional	TC	$45.45	$47.23	$51.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $32.34 / $70.90	Professional		$17.35	$32.34	$70.90
United Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $62.11 / $95.02	Professional		$46.87	$62.11	$95.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.21 / $17.44 / $28.45	Professional	26	$13.21	$17.44	$28.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.92 / $69.29	Professional	TC	$33.88	$44.92	$69.29