Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $22.91 / $46.77	Facility	26	$13.80	$22.91	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $194.98	Professional		$40.74	$61.66	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.44 / $54.95	Professional	26	$12.88	$23.44	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $75.86	Professional	TC	$26.92	$37.15	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $79.43	Professional		$33.11	$38.02	$79.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.59 / $20.89	Professional	26	$11.48	$12.59	$20.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.30 / $42.66	Professional	TC	$21.38	$26.30	$42.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $50.12 / $112.20	Professional		$19.50	$50.12	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $95.50	Professional		$40.74	$63.10	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $21.38 / $30.90	Professional	26	$13.18	$21.38	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.69 / $64.57	Professional	TC	$27.54	$41.69	$64.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $112.20 / $234.42	Professional		$57.54	$112.20	$234.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $31.62 / $169.82	Professional	26	$18.62	$31.62	$169.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $58.88 / $162.18	Professional	TC	$36.31	$58.88	$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 $58.88 / $60.26 / $66.07	Professional		$58.88	$60.26	$66.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.05 / $20.42	Professional	26	$18.62	$19.05	$20.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $41.69 / $44.67	Professional	TC	$39.81	$41.69	$44.67
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 $44.67 / $57.54 / $85.11	Professional		$44.67	$57.54	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $29.51	Professional	26	$14.79	$18.62	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.02 / $57.54	Professional	TC	$28.84	$38.02	$57.54