Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.96 / $38.26 / $43.47	Facility	26	$21.96	$38.26	$43.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $72.02 / $266.00	Professional		$39.54	$72.02	$266.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $30.05 / $130.00	Professional	26	$20.69	$30.05	$130.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $23.10 / $40.47	Professional	TC	$17.72	$23.10	$40.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $33.71 / $57.72	Professional		$31.73	$33.71	$57.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $27.88 / $31.36	Professional	26	$25.55	$27.88	$31.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $54.42 / $99.58	Professional		$29.07	$54.42	$99.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $64.01 / $104.36	Professional		$38.36	$64.01	$104.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.67 / $32.52 / $47.79	Professional	26	$20.67	$32.52	$47.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $30.63 / $72.61	Professional	TC	$18.70	$30.63	$72.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $71.17 / $345.61	Professional		$48.47	$71.17	$345.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $37.77 / $163.35	Professional	26	$25.55	$37.77	$163.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.70 / $32.83 / $241.21	Professional	TC	$22.70	$32.83	$241.21
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 $52.87 / $53.50 / $57.28	Professional		$52.87	$53.50	$57.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.81 / $28.89 / $30.20	Professional	26	$28.81	$28.89	$30.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.97 / $24.69 / $27.09	Professional	TC	$23.97	$24.69	$27.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $32.34 / $59.92	Professional		$26.05	$32.34	$59.92
United Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $59.86 / $101.51	Professional		$45.21	$59.86	$101.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $29.91 / $47.53	Professional	26	$22.70	$29.91	$47.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $28.62 / $53.13	Professional	TC	$19.82	$28.62	$53.13