Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.77 / $38.63 / $48.98	Facility	26	$19.77	$38.63	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $65.88 / $115.81	Professional		$55.14	$65.88	$115.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $20.82 / $38.63	Professional	26	$18.28	$20.82	$38.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.69 / $44.76 / $76.81	Professional	TC	$36.69	$44.76	$76.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $27.66 / $34.74	Professional	26	$15.78	$27.66	$34.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.20 / $76.04 / $145.77	Professional		$26.20	$76.04	$145.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $87.83 / $132.32	Professional		$54.55	$87.83	$132.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $29.22 / $44.56	Professional	26	$17.60	$29.22	$44.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.20 / $59.52 / $88.06	Professional	TC	$37.20	$59.52	$88.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.44 / $113.40 / $271.89	Professional		$75.44	$113.40	$271.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.02 / $32.02 / $84.54	Professional	26	$23.02	$32.02	$84.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.13 / $66.98 / $140.41	Professional	TC	$49.13	$66.98	$140.41
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 $77.39 / $78.88 / $85.28	Professional		$77.39	$78.88	$85.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.13 / $25.22 / $27.21	Professional	26	$23.13	$25.22	$27.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.35 / $51.58 / $58.06	Professional	TC	$49.35	$51.58	$58.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $32.34 / $89.22	Professional		$28.46	$32.34	$89.22
United Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $80.48 / $118.27	Professional		$63.30	$80.48	$118.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.77 / $27.34 / $42.32	Professional	26	$21.77	$27.34	$42.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.25 / $53.96 / $78.28	Professional	TC	$41.25	$53.96	$78.28