Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.44 / $21.87 / $27.32	Facility	26	$13.44	$21.87	$27.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $55.15 / $87.24	Professional		$35.29	$55.15	$87.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.27 / $15.37 / $34.78	Professional	26	$13.27	$15.37	$34.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $36.78 / $65.70	Professional	TC	$21.84	$36.78	$65.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $11.45 / $25.10	Professional	26	$11.07	$11.45	$25.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $48.47 / $92.92	Professional		$19.23	$48.47	$92.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $62.52 / $93.01	Professional		$33.35	$62.52	$93.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.76 / $21.00 / $32.03	Professional	26	$12.76	$21.00	$32.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.73 / $39.59 / $67.73	Professional	TC	$20.73	$39.59	$67.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.39 / $75.29 / $279.95	Professional		$48.39	$75.29	$279.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $26.13 / $134.56	Professional	26	$18.44	$26.13	$134.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.28 / $44.88 / $183.49	Professional	TC	$29.28	$44.88	$183.49
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 $49.34 / $49.69 / $54.38	Professional		$49.34	$49.69	$54.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $18.84 / $19.98	Professional	26	$18.16	$18.84	$19.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.50 / $31.53 / $34.40	Professional	TC	$30.50	$31.53	$34.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $32.34 / $56.89	Professional		$20.90	$32.34	$56.89
United Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $59.71 / $98.51	Professional		$39.29	$59.71	$98.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $19.14 / $30.16	Professional	26	$15.48	$19.14	$30.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $36.36 / $67.84	Professional	TC	$23.31	$36.36	$67.84