Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.33 / $12.57 / $17.17	Facility	26	$8.33	$12.57	$17.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $70.59 / $236.75	Professional		$32.97	$70.59	$236.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $10.37 / $57.03	Professional	26	$8.68	$10.37	$57.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.03 / $48.16 / $96.77	Professional	TC	$24.03	$48.16	$96.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.63 / $35.35 / $40.72	Professional		$25.63	$35.35	$40.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $8.94 / $12.68	Professional	26	$6.83	$8.94	$12.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.08 / $34.71 / $36.04	Professional	TC	$24.08	$34.71	$36.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.87 / $39.25 / $87.38	Professional		$11.87	$39.25	$87.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.82 / $59.38 / $139.88	Professional		$33.82	$59.38	$139.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $13.17 / $20.63	Professional	26	$7.95	$13.17	$20.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $46.06 / $117.59	Professional	TC	$25.19	$46.06	$117.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $67.97 / $653.57	Professional		$44.26	$67.97	$653.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $16.59 / $108.12	Professional	26	$10.89	$16.59	$108.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $48.41 / $486.99	Professional	TC	$33.26	$48.41	$486.99
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 $46.38 / $47.32 / $51.47	Professional		$46.38	$47.32	$51.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.36 / $11.67 / $12.32	Professional	26	$11.36	$11.67	$12.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.71 / $35.96 / $39.13	Professional	TC	$34.71	$35.96	$39.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.89 / $32.34 / $53.84	Professional		$12.89	$32.34	$53.84
United Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $59.09 / $107.18	Professional		$39.93	$59.09	$107.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $11.95 / $20.29	Professional	26	$8.53	$11.95	$20.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.87 / $46.77 / $95.44	Professional	TC	$29.87	$46.77	$95.44