Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.90 / $15.39 / $25.63	Facility	26	$13.90	$15.39	$25.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $70.68 / $109.99	Professional		$37.11	$70.68	$109.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $14.98 / $34.01	Professional	26	$7.33	$14.98	$34.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $48.37 / $103.97	Professional	TC	$23.48	$48.37	$103.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $15.35 / $16.48	Professional	26	$11.00	$15.35	$16.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $50.48 / $96.77	Professional		$19.64	$50.48	$96.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.71 / $65.73 / $115.57	Professional		$39.71	$65.73	$115.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $16.89 / $28.15	Professional	26	$9.10	$16.89	$28.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.18 / $45.83 / $93.83	Professional	TC	$26.18	$45.83	$93.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $74.42 / $291.18	Professional		$50.39	$74.42	$291.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $24.56 / $151.38	Professional	26	$16.04	$24.56	$151.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.79 / $49.86 / $176.42	Professional	TC	$31.79	$49.86	$176.42
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 $51.38 / $51.40 / $56.97	Professional		$51.38	$51.40	$56.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.86 / $18.95 / $20.41	Professional	26	$17.86	$18.95	$20.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $33.54 / $36.56	Professional	TC	$32.40	$33.54	$36.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $32.34 / $59.60	Professional		$21.35	$32.34	$59.60
United Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $68.14 / $107.99	Professional		$42.90	$68.14	$107.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $17.10 / $30.11	Professional	26	$8.84	$17.10	$30.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $44.86 / $94.03	Professional	TC	$26.71	$44.86	$94.03