Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $15.49 / $32.36	Facility	26	$9.55	$15.49	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $173.78	Professional		$31.62	$52.48	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.60 / $39.81	Professional	26	$8.91	$16.60	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $72.44	Professional	TC	$21.88	$31.62	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $30.90 / $39.81	Professional		$29.51	$30.90	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $15.49	Professional	26	$8.13	$10.00	$15.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.30 / $34.67	Professional	TC	$19.50	$26.30	$34.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $45.71 / $81.28	Professional		$13.49	$45.71	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $70.79	Professional		$30.90	$47.86	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.49 / $20.42	Professional	26	$8.71	$13.49	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $34.67 / $53.70	Professional	TC	$22.39	$34.67	$53.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $91.20 / $245.47	Professional		$43.65	$91.20	$245.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.38 / $77.62	Professional	26	$12.88	$21.38	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $162.18	Professional	TC	$31.62	$47.86	$162.18
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 $46.77 / $47.86 / $51.29	Professional		$46.77	$47.86	$51.29
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 $33.11 / $34.67 / $37.15	Professional	TC	$33.11	$34.67	$37.15
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 $33.11 / $43.65 / $66.07	Professional		$33.11	$43.65	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $20.42	Professional	26	$9.55	$12.59	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.62 / $46.77	Professional	TC	$23.44	$31.62	$46.77