Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.23 / $35.29 / $42.18	Facility	26	$22.23	$35.29	$42.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.49 / $82.34 / $330.97	Professional		$42.49	$82.34	$330.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $29.93 / $109.54	Professional	26	$16.92	$29.93	$109.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $37.24 / $89.57	Professional	TC	$21.02	$37.24	$89.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.14 / $37.67 / $68.42	Professional		$30.14	$37.67	$68.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $20.61 / $30.62	Professional	26	$17.30	$20.61	$30.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.02 / $32.02 / $36.60	Professional	TC	$32.02	$32.02	$36.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $58.93 / $107.31	Professional		$29.47	$58.93	$107.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $75.51 / $135.31	Professional		$43.52	$75.51	$135.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $30.14 / $44.04	Professional	26	$18.71	$30.14	$44.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $40.19 / $106.31	Professional	TC	$21.82	$40.19	$106.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.37 / $86.49 / $293.23	Professional		$55.37	$86.49	$293.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.91 / $37.03 / $178.76	Professional	26	$25.91	$37.03	$178.76
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.47 / $42.75 / $179.43	Professional	TC	$29.47	$42.75	$179.43
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 $59.97 / $60.48 / $65.44	Professional		$59.97	$60.48	$65.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $29.09 / $30.62	Professional	26	$28.55	$29.09	$30.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.88 / $31.93 / $34.83	Professional	TC	$30.88	$31.93	$34.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $32.34 / $74.00	Professional		$32.03	$32.34	$74.00
United Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $74.17 / $126.62	Professional		$48.59	$74.17	$126.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $27.56 / $45.50	Professional	26	$20.16	$27.56	$45.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.05 / $36.79 / $99.54	Professional	TC	$23.05	$36.79	$99.54