Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $36.82 / $48.65	Facility	26	$24.54	$36.82	$48.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.35 / $101.07 / $333.93	Professional		$51.35	$101.07	$333.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.54 / $35.49 / $108.63	Professional	26	$24.54	$35.49	$108.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.24 / $47.07 / $119.29	Professional	TC	$26.24	$47.07	$119.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $48.63 / $61.80	Professional		$36.57	$48.63	$61.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.18 / $28.23 / $37.53	Professional	26	$20.18	$28.23	$37.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.74 / $45.74 / $45.74	Professional	TC	$45.74	$45.74	$45.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $69.67 / $137.00	Professional		$34.79	$69.67	$137.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $91.82 / $159.66	Professional		$52.72	$91.82	$159.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.58 / $37.86 / $55.60	Professional	26	$23.58	$37.86	$55.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.25 / $50.12 / $106.20	Professional	TC	$27.25	$50.12	$106.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.33 / $104.03 / $338.67	Professional		$67.33	$104.03	$338.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $44.48 / $159.87	Professional	26	$30.70	$44.48	$159.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.75 / $54.85 / $184.11	Professional	TC	$36.75	$54.85	$184.11
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 $72.73 / $73.23 / $79.56	Professional		$72.73	$73.23	$79.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.25 / $34.19 / $36.14	Professional	26	$33.25	$34.19	$36.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $39.97 / $43.43	Professional	TC	$38.54	$39.97	$43.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.82 / $83.25	Professional		$32.34	$36.82	$83.25
United Facility/Professional Professional Modifier Low / Median / High Price $59.70 / $90.37 / $145.44	Professional		$59.70	$90.37	$145.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $35.51 / $55.61	Professional	26	$27.75	$35.51	$55.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.66 / $47.27 / $95.04	Professional	TC	$29.66	$47.27	$95.04