Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.58 / $23.70 / $27.27	Facility	26	$14.58	$23.70	$27.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $45.01 / $76.25	Professional		$37.59	$45.01	$76.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $15.92 / $28.71	Professional	26	$14.08	$15.92	$28.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.79 / $41.09	Professional	TC	$23.51	$28.79	$41.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $15.16 / $21.66	Professional	26	$12.13	$15.16	$21.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.88 / $54.16 / $103.83	Professional		$20.88	$54.16	$103.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $61.80 / $87.50	Professional		$36.42	$61.80	$87.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $21.69 / $33.67	Professional	26	$13.88	$21.69	$33.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.95 / $40.64 / $57.96	Professional	TC	$22.95	$40.64	$57.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.81 / $81.88 / $277.39	Professional		$53.81	$81.88	$277.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.95 / $28.37 / $110.53	Professional	26	$18.95	$28.37	$110.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $45.15 / $123.94	Professional	TC	$33.11	$45.15	$123.94
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 $55.12 / $55.74 / $60.83	Professional		$55.12	$55.74	$60.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $20.41 / $21.70	Professional	26	$19.79	$20.41	$21.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $34.71 / $39.13	Professional	TC	$33.26	$34.71	$39.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $32.34 / $63.63	Professional		$22.70	$32.34	$63.63
United Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $56.49 / $86.87	Professional		$43.22	$56.49	$86.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.38 / $21.47 / $33.38	Professional	26	$16.38	$21.47	$33.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.76 / $34.61 / $56.09	Professional	TC	$25.76	$34.61	$56.09