Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.44 / $18.32 / $20.69	Facility	26	$11.44	$18.32	$20.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.82 / $42.57 / $80.98	Professional		$35.82	$42.57	$80.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $12.19 / $29.94	Professional	26	$9.75	$12.19	$29.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $31.64 / $51.77	Professional	TC	$25.14	$31.64	$51.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $39.86 / $42.40	Professional		$34.78	$39.86	$42.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $12.04 / $15.71	Professional	26	$9.16	$12.04	$15.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $48.78 / $85.81	Professional		$15.15	$48.78	$85.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $54.11 / $79.78	Professional		$34.46	$54.11	$79.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $15.57 / $23.51	Professional	26	$9.42	$15.57	$23.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $38.79 / $59.68	Professional	TC	$25.19	$38.79	$59.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.03 / $68.66 / $221.46	Professional		$47.03	$68.66	$221.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.00 / $20.59 / $88.35	Professional	26	$14.00	$20.59	$88.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $48.06 / $153.29	Professional	TC	$33.11	$48.06	$153.29
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 $49.65 / $50.64 / $54.87	Professional		$49.65	$50.64	$54.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.68 / $14.92 / $15.74	Professional	26	$14.68	$14.92	$15.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.71 / $35.96 / $39.13	Professional	TC	$34.71	$35.96	$39.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.47 / $32.34 / $57.41	Professional		$16.47	$32.34	$57.41
United Facility/Professional Professional Modifier Low / Median / High Price $39.02 / $50.26 / $74.05	Professional		$39.02	$50.26	$74.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $14.49 / $24.03	Professional	26	$10.88	$14.49	$24.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.74 / $36.36 / $52.94	Professional	TC	$26.74	$36.36	$52.94