Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $13.18 / $28.18	Facility	26	$8.32	$13.18	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $66.07 / $288.40	Professional		$32.36	$66.07	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.30 / $48.98	Professional	26	$8.32	$12.30	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $151.36	Professional	TC	$22.91	$40.74	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $29.51 / $42.66	Professional		$23.99	$29.51	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.12 / $14.79	Professional	26	$6.92	$9.12	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $40.74	Professional	TC	$21.88	$28.18	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $38.90 / $87.10	Professional		$11.75	$38.90	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $58.88 / $144.54	Professional		$33.88	$58.88	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.18 / $20.42	Professional	26	$8.32	$13.18	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $45.71 / $125.89	Professional	TC	$25.70	$45.71	$125.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $125.89 / $660.69	Professional		$46.77	$125.89	$660.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $28.18 / $190.55	Professional	26	$11.22	$28.18	$190.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $60.26 / $489.78	Professional	TC	$33.88	$60.26	$489.78
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 $46.77 / $47.86 / $51.29	Professional		$46.77	$47.86	$51.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $11.75 / $12.30	Professional	26	$11.48	$11.75	$12.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $38.90	Professional	TC	$34.67	$36.31	$38.90
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 $38.02 / $58.88 / $123.03	Professional		$38.02	$58.88	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.22 / $18.20	Professional	26	$8.13	$11.22	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $102.33	Professional	TC	$28.18	$44.67	$102.33