Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.12 / $22.14 / $27.87	Facility	26	$13.12	$22.14	$27.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.29 / $75.19 / $142.18	Professional		$52.29	$75.19	$142.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $17.27 / $31.52	Professional	26	$13.12	$17.27	$31.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.17 / $51.21 / $84.27	Professional	TC	$39.17	$51.21	$84.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $55.21 / $62.19	Professional		$39.93	$55.21	$62.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $15.80 / $21.00	Professional	26	$10.88	$15.80	$21.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.82 / $71.01 / $124.80	Professional		$18.82	$71.01	$124.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $83.53 / $127.53	Professional		$52.45	$83.53	$127.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $21.43 / $32.56	Professional	26	$12.64	$21.43	$32.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $62.98 / $94.96	Professional	TC	$39.22	$62.98	$94.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.88 / $104.89 / $318.22	Professional		$70.88	$104.89	$318.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.03 / $26.34 / $110.50	Professional	26	$18.03	$26.34	$110.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.32 / $74.61 / $207.72	Professional	TC	$51.32	$74.61	$207.72
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 $72.27 / $73.80 / $80.20	Professional		$72.27	$73.80	$80.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.72 / $18.38 / $19.57	Professional	26	$17.72	$18.38	$19.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.89 / $56.08 / $60.65	Professional	TC	$53.89	$56.08	$60.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $32.34 / $83.91	Professional		$20.47	$32.34	$83.91
United Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $79.59 / $116.47	Professional		$59.77	$79.59	$116.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $20.18 / $29.82	Professional	26	$15.30	$20.18	$29.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.47 / $58.45 / $89.50	Professional	TC	$44.47	$58.45	$89.50