Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $41.69 / $69.18	Facility	26	$20.89	$41.69	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $263.03	Professional		$38.90	$77.62	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $41.69 / $123.03	Professional	26	$20.42	$41.69	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $50.12	Professional	TC	$16.98	$23.99	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $48.98	Professional		$30.20	$35.48	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.44 / $40.74	Professional	26	$18.20	$23.44	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $15.49 / $23.44	Professional	TC	$14.13	$15.49	$23.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $100.00	Professional		$28.84	$54.95	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $63.10 / $107.15	Professional		$38.02	$63.10	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $50.12	Professional	26	$20.42	$33.11	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $29.51 / $66.07	Professional	TC	$18.20	$29.51	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $120.23 / $457.09	Professional		$48.98	$120.23	$457.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $50.12 / $162.18	Professional	26	$25.70	$50.12	$162.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $41.69 / $331.13	Professional	TC	$21.88	$41.69	$331.13
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 $52.48 / $53.70 / $57.54	Professional		$52.48	$53.70	$57.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $30.20	Professional	26	$28.84	$28.84	$30.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $24.55 / $26.92	Professional	TC	$23.99	$24.55	$26.92
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 $42.66 / $57.54 / $100.00	Professional		$42.66	$57.54	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $45.71	Professional	26	$22.91	$28.84	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $58.88	Professional	TC	$19.50	$26.92	$58.88