Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $18.62 / $32.36	Facility	26	$9.55	$18.62	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $204.17	Professional		$33.88	$56.23	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.98 / $41.69	Professional	26	$8.91	$16.98	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $72.44	Professional	TC	$23.99	$36.31	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $32.36 / $54.95	Professional		$26.30	$32.36	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.23 / $17.38	Professional	26	$10.00	$10.23	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $21.88 / $23.99	Professional	TC	$21.88	$21.88	$23.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $46.77 / $83.18	Professional		$13.49	$46.77	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $87.10	Professional		$34.67	$56.23	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.79 / $22.91	Professional	26	$9.12	$14.79	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $64.57	Professional	TC	$26.30	$41.69	$64.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $239.88	Professional		$48.98	$100.00	$239.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.39 / $83.18	Professional	26	$12.88	$22.39	$83.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $60.26 / $169.82	Professional	TC	$34.67	$60.26	$169.82
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 $47.86 / $48.98 / $53.70	Professional		$47.86	$48.98	$53.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.18 / $14.13	Professional	26	$12.88	$13.18	$14.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $38.90	Professional	TC	$34.67	$36.31	$38.90
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 $38.02 / $51.29 / $74.13	Professional		$38.02	$51.29	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $20.42	Professional	26	$10.72	$13.49	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $54.95	Professional	TC	$26.92	$37.15	$54.95