Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $41.69 / $100.00	Facility	26	$29.51	$41.69	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $69.18 / $218.78	Professional		$32.36	$69.18	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $48.98 / $123.03	Professional	26	$21.88	$48.98	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $69.18 / $263.03	Professional	50	$36.31	$69.18	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $26.30 / $72.44	Professional	TC	$7.94	$26.30	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $87.10	Professional		$41.69	$50.12	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $53.70	Professional	26	$24.55	$30.20	$53.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.92 / $41.69	Professional	TC	$21.38	$26.92	$41.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $77.62 / $144.54	Professional		$41.69	$77.62	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $61.66 / $107.15	Professional		$33.11	$61.66	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $34.67 / $60.26	Professional	26	$21.38	$34.67	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $30.20 / $56.23	Professional	TC	$10.96	$30.20	$56.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $223.87	Professional		$72.44	$128.82	$223.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $63.10 / $151.36	Professional	26	$37.15	$63.10	$151.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $44.67 / $95.50	Professional	TC	$19.95	$44.67	$95.50
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 $77.62 / $77.62 / $85.11	Professional		$77.62	$77.62	$85.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $43.65	Professional	26	$39.81	$40.74	$43.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $38.02 / $41.69	Professional	TC	$36.31	$38.02	$41.69
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 $34.67 / $57.54 / $100.00	Professional		$34.67	$57.54	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $44.67	Professional	26	$21.88	$28.84	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $31.62 / $54.95	Professional	TC	$10.96	$31.62	$54.95