Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $16.22 / $28.18	Facility	26	$8.91	$16.22	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $45.71 / $338.84	Professional		$22.91	$45.71	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $54.95	Professional	26	$8.91	$12.02	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $21.88 / $120.23	Professional	TC	$12.88	$21.88	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $19.95 / $34.67	Professional		$18.62	$19.95	$34.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.13 / $12.30	Professional	26	$6.92	$8.13	$12.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	TC	$14.79	$14.79	$14.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $30.20 / $57.54	Professional		$11.75	$30.20	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	26	$12.59	$12.59	$12.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $38.90 / $144.54	Professional		$19.95	$38.90	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $19.95	Professional	26	$8.13	$13.18	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $24.55 / $134.90	Professional	TC	$12.59	$24.55	$134.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $120.23 / $524.81	Professional		$30.20	$120.23	$524.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $21.38 / $109.65	Professional	26	$10.96	$21.38	$109.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $24.55 / $346.74	Professional	TC	$17.38	$24.55	$346.74
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 $30.90 / $30.90 / $33.88	Professional		$30.90	$30.90	$33.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $11.75 / $12.30	Professional	26	$11.48	$11.75	$12.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.05 / $21.38	Professional	TC	$18.20	$19.05	$21.38
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 $22.39 / $38.90 / $144.54	Professional		$22.39	$38.90	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $18.20	Professional	26	$9.12	$12.02	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $21.38 / $123.03	Professional	TC	$12.59	$21.38	$123.03