Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.65 / $21.92 / $24.32	Facility	26	$12.65	$21.92	$24.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $43.18 / $101.42	Professional		$34.85	$43.18	$101.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $14.87 / $31.95	Professional	26	$11.64	$14.87	$31.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.30 / $21.48 / $31.85	Professional	52	$18.30	$21.48	$31.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $29.46 / $55.76	Professional	TC	$22.26	$29.46	$55.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $42.98 / $42.98	Professional		$39.69	$42.98	$42.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $17.63 / $19.59	Professional	26	$12.00	$17.63	$19.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $45.45 / $101.17	Professional		$16.79	$45.45	$101.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $57.29 / $85.71	Professional		$34.94	$57.29	$85.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $18.11 / $28.25	Professional	26	$11.46	$18.11	$28.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $38.94 / $60.62	Professional	TC	$23.06	$38.94	$60.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $78.70 / $264.52	Professional		$52.68	$78.70	$264.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $20.34 / $62.36	Professional	26	$14.75	$20.34	$62.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $48.63 / $103.79	Professional	TC	$35.65	$48.63	$103.79
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 $53.72 / $54.41 / $59.58	Professional		$53.72	$54.41	$59.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $15.64 / $17.43	Professional	26	$14.82	$15.64	$17.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.82 / $37.40 / $42.15	Professional	TC	$35.82	$37.40	$42.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.23 / $32.34 / $62.33	Professional		$18.23	$32.34	$62.33
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $51.46 / $82.97	Professional		$39.47	$51.46	$82.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $19.70 / $39.92	Professional	26	$13.71	$19.70	$39.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.94 / $38.61 / $76.78	Professional	TC	$24.94	$38.61	$76.78