Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $15.85 / $27.54	Facility	26	$7.94	$15.85	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $40.74 / $120.23	Professional		$23.99	$40.74	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.18 / $37.15	Professional	26	$7.08	$13.18	$37.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $53.70 / $158.49	Professional	52	$30.20	$53.70	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $24.55 / $53.70	Professional	TC	$15.85	$24.55	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $20.42	Professional		$19.95	$19.95	$20.42
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $4.47 / $5.25 / $9.12	Professional	52	$4.47	$5.25	$9.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $33.88 / $58.88	Professional		$11.48	$33.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $67.61	Professional		$25.12	$42.66	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.88 / $20.42	Professional	26	$8.13	$12.88	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.20 / $48.98	Professional	TC	$18.62	$30.20	$48.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $199.53	Professional		$34.67	$74.13	$199.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.05 / $64.57	Professional	26	$10.96	$19.05	$64.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $40.74 / $131.83	Professional	TC	$23.44	$40.74	$131.83
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 $34.67 / $34.67 / $38.02	Professional		$34.67	$34.67	$38.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $12.02	Professional	26	$10.96	$11.22	$12.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.99 / $26.30	Professional	TC	$23.44	$23.99	$26.30
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 $30.20 / $41.69 / $61.66	Professional		$30.20	$41.69	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.02 / $18.62	Professional	26	$9.33	$12.02	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $42.66	Professional	TC	$20.89	$28.84	$42.66