Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $24.32 / $32.15	Facility	26	$12.36	$24.32	$32.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.94 / $56.44 / $115.98	Professional		$42.94	$56.44	$115.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $13.40 / $25.87	Professional	26	$11.49	$13.40	$25.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $42.80 / $82.01	Professional	TC	$34.14	$42.80	$82.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.07 / $57.50 / $57.50	Professional		$50.07	$57.50	$57.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $12.73 / $18.55	Professional	26	$9.81	$12.73	$18.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $60.41 / $134.47	Professional		$17.20	$60.41	$134.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.95 / $74.13 / $114.16	Professional		$44.95	$74.13	$114.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $18.55 / $28.47	Professional	26	$11.20	$18.55	$28.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.10 / $56.26 / $88.47	Professional	TC	$35.10	$56.26	$88.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.01 / $102.49 / $276.51	Professional		$70.01	$102.49	$276.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $23.36 / $90.02	Professional	26	$16.05	$23.36	$90.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $68.59 / $161.16	Professional	TC	$48.13	$68.59	$161.16
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 $71.38 / $72.94 / $79.37	Professional		$71.38	$72.94	$79.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $16.73 / $17.86	Professional	26	$16.05	$16.73	$17.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.28 / $54.65 / $61.50	Professional	TC	$52.28	$54.65	$61.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.69 / $32.34 / $83.03	Professional		$18.69	$32.34	$83.03
United Facility/Professional Professional Modifier Low / Median / High Price $50.99 / $68.08 / $106.03	Professional		$50.99	$68.08	$106.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $17.45 / $27.10	Professional	26	$13.81	$17.45	$27.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.02 / $50.95 / $78.42	Professional	TC	$37.02	$50.95	$78.42