Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.73 / $23.15 / $27.32	Facility	26	$13.73	$23.15	$27.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $50.31 / $111.23	Professional		$42.44	$50.31	$111.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $18.32 / $40.00	Professional	26	$13.58	$18.32	$40.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $34.03 / $61.53	Professional	TC	$28.72	$34.03	$61.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $48.73 / $48.73	Professional		$37.13	$48.73	$48.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $13.56 / $21.98	Professional	26	$10.64	$13.56	$21.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $41.69 / $46.90	Professional	TC	$29.51	$41.69	$46.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $58.27 / $111.70	Professional		$19.64	$58.27	$111.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.71 / $64.56 / $94.31	Professional		$40.71	$64.56	$94.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.04 / $21.19 / $32.63	Professional	26	$13.04	$21.19	$32.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.70 / $64.95	Professional	TC	$27.54	$43.70	$64.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $84.03 / $207.44	Professional		$56.40	$84.03	$207.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.84 / $26.60 / $93.49	Professional	26	$18.84	$26.60	$93.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.56 / $54.90 / $135.47	Professional	TC	$37.56	$54.90	$135.47
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 $59.31 / $60.15 / $65.56	Professional		$59.31	$60.15	$65.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $19.21 / $20.41	Professional	26	$18.55	$19.21	$20.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.08 / $41.59 / $45.16	Professional	TC	$40.08	$41.59	$45.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $32.34 / $68.59	Professional		$21.35	$32.34	$68.59
United Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $58.96 / $91.82	Professional		$46.33	$58.96	$91.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.64 / $19.48 / $31.17	Professional	26	$15.64	$19.48	$31.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $40.19 / $61.66	Professional	TC	$30.14	$40.19	$61.66