Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.41 / $14.51 / $25.63	Facility	26	$13.41	$14.51	$25.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $35.76 / $63.35	Professional		$17.14	$35.76	$63.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $14.51 / $35.79	Professional	26	$7.03	$14.51	$35.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $22.39 / $39.09	Professional	TC	$10.11	$22.39	$39.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $38.83 / $43.49	Professional		$33.89	$38.83	$43.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $16.14 / $20.48	Professional	26	$11.14	$16.14	$20.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $50.32 / $96.46	Professional		$19.23	$50.32	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.88 / $43.18 / $77.42	Professional		$20.88	$43.18	$77.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $16.05 / $27.67	Professional	26	$8.84	$16.05	$27.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.57 / $27.63 / $50.05	Professional	TC	$11.57	$27.63	$50.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.49 / $69.58 / $125.01	Professional		$43.49	$69.58	$125.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.91 / $24.17 / $81.34	Professional	26	$15.91	$24.17	$81.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $38.14 / $76.26	Professional	TC	$19.94	$38.14	$76.26
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 $51.21 / $51.69 / $56.54	Professional		$51.21	$51.69	$56.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $18.80 / $19.98	Professional	26	$18.14	$18.80	$19.98
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 $20.90 / $32.34 / $59.15	Professional		$20.90	$32.34	$59.15
United Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $41.49 / $78.61	Professional		$19.84	$41.49	$78.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $16.02 / $30.20	Professional	26	$8.30	$16.02	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.33 / $24.68 / $50.71	Professional	TC	$11.33	$24.68	$50.71