Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.94 / $13.55 / $16.62	Facility	26	$9.94	$13.55	$16.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.66 / $42.64 / $171.00	Professional		$23.66	$42.64	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.27 / $35.04	Professional	26	$8.83	$10.27	$35.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.11 / $22.99 / $92.72	Professional	TC	$14.11	$22.99	$92.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.45 / $19.11 / $28.62	Professional		$15.45	$19.11	$28.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $7.98 / $12.42	Professional	26	$6.76	$7.98	$12.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.87 / $30.13 / $57.76	Professional		$11.87	$30.13	$57.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.55 / $12.55 / $12.55	Facility	26	$12.55	$12.55	$12.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $39.03 / $154.77	Professional		$20.12	$39.03	$154.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.80 / $20.01	Professional	26	$7.95	$12.80	$20.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.73 / $24.80 / $143.07	Professional	TC	$12.73	$24.80	$143.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $44.94 / $412.80	Professional		$29.92	$44.94	$412.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $16.59 / $78.42	Professional	26	$10.89	$16.59	$78.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $24.81 / $254.70	Professional	TC	$18.09	$24.81	$254.70
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 $30.67 / $30.82 / $33.83	Professional		$30.67	$30.82	$33.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.36 / $11.67 / $12.32	Professional	26	$11.36	$11.67	$12.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $18.98 / $21.50	Professional	TC	$18.28	$18.98	$21.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.89 / $32.34 / $35.39	Professional		$12.89	$32.34	$35.39
United Facility/Professional Professional Modifier Low / Median / High Price $23.46 / $39.64 / $134.51	Professional		$23.46	$39.64	$134.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.61 / $20.64	Professional	26	$10.02	$12.61	$20.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $21.95 / $90.74	Professional	TC	$13.35	$21.95	$90.74