Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.41 / $20.23 / $27.27	Facility	26	$13.41	$20.23	$27.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $60.35 / $145.18	Professional		$51.49	$60.35	$145.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $16.12 / $75.65	Professional	26	$13.42	$16.12	$75.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $43.83 / $74.47	Professional	TC	$37.11	$43.83	$74.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $47.56 / $60.20	Professional		$40.36	$47.56	$60.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $15.00 / $20.75	Professional	26	$11.44	$15.00	$20.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.01 / $46.94 / $64.45	Professional	TC	$40.01	$46.94	$64.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $71.80 / $137.63	Professional		$19.23	$71.80	$137.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.13 / $78.16 / $116.60	Professional		$49.13	$78.16	$116.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $20.75 / $32.03	Professional	26	$12.79	$20.75	$32.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.20 / $58.72 / $87.85	Professional	TC	$36.20	$58.72	$87.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $107.08 / $290.10	Professional		$71.67	$107.08	$290.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $23.14 / $64.87	Professional	26	$16.91	$23.14	$64.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.68 / $70.47 / $172.48	Professional	TC	$51.68	$70.47	$172.48
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 $73.06 / $74.62 / $81.06	Professional		$73.06	$74.62	$81.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $18.14 / $19.98	Professional	26	$16.98	$18.14	$19.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.91 / $54.28 / $61.07	Professional	TC	$51.91	$54.28	$61.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $32.34 / $84.80	Professional		$20.90	$32.34	$84.80
United Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $74.29 / $110.12	Professional		$55.65	$74.29	$110.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $20.39 / $31.19	Professional	26	$15.66	$20.39	$31.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.59 / $53.44 / $84.56	Professional	TC	$38.59	$53.44	$84.56