Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $20.42 / $41.69	Facility	26	$11.48	$20.42	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $66.07 / $181.97	Professional		$38.02	$66.07	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $43.65	Professional	26	$10.96	$17.78	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $45.71 / $97.72	Professional	TC	$33.88	$45.71	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $87.10	Professional		$41.69	$48.98	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.22 / $19.50	Professional	26	$10.23	$11.22	$19.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $60.26 / $134.90	Professional		$17.38	$60.26	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $70.79 / $109.65	Professional		$46.77	$70.79	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.62 / $28.18	Professional	26	$11.48	$18.62	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $53.70 / $85.11	Professional	TC	$35.48	$53.70	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $316.23	Professional		$70.79	$123.03	$316.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $34.67 / $97.72	Professional	26	$16.22	$34.67	$97.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $67.61 / $194.98	Professional	TC	$46.77	$67.61	$194.98
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 $70.79 / $72.44 / $79.43	Professional		$70.79	$72.44	$79.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.60 / $17.78	Professional	26	$16.22	$16.60	$17.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $54.95 / $61.66	Professional	TC	$52.48	$54.95	$61.66
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 $50.12 / $66.07 / $97.72	Professional		$50.12	$66.07	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.98 / $25.70	Professional	26	$13.49	$16.98	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $48.98 / $72.44	Professional	TC	$35.48	$48.98	$72.44