Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $22.91 / $39.81	Facility	26	$12.02	$22.91	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $173.78	Professional		$34.67	$56.23	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $53.70	Professional	26	$10.96	$20.42	$53.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.77 / $144.54 / $144.54	Professional	52	$46.77	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $63.10	Professional	TC	$22.39	$33.11	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $61.66	Professional		$30.20	$38.90	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $20.89	Professional	26	$10.00	$12.02	$20.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.11 / $45.71	Professional	TC	$32.36	$33.11	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $52.48 / $102.33	Professional		$16.98	$52.48	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $83.18	Professional		$34.67	$53.70	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.20 / $27.54	Professional	26	$11.48	$18.20	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $57.54	Professional	TC	$22.91	$37.15	$57.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $131.83 / $263.03	Professional		$53.70	$131.83	$263.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.95 / $74.13	Professional	26	$14.45	$19.95	$74.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.86 / $165.96	Professional	TC	$34.67	$47.86	$165.96
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 $53.70 / $54.95 / $60.26	Professional		$53.70	$54.95	$60.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $17.38	Professional	26	$14.79	$15.49	$17.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $37.15 / $41.69	Professional	TC	$35.48	$37.15	$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 $37.15 / $50.12 / $75.86	Professional		$37.15	$50.12	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.60 / $26.30	Professional	26	$12.88	$16.60	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $52.48	Professional	TC	$23.99	$33.88	$52.48