Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.61 / $21.67 / $25.57	Facility	26	$13.61	$21.67	$25.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $51.43 / $95.15	Professional		$43.65	$51.43	$95.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $14.06 / $25.57	Professional	26	$12.61	$14.06	$25.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $37.71 / $69.03	Professional	TC	$30.92	$37.71	$69.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $38.49 / $51.22	Professional		$32.22	$38.49	$51.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $14.06 / $19.64	Professional	26	$14.06	$14.06	$19.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.60 / $62.72 / $120.23	Professional		$17.60	$62.72	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.70 / $72.05 / $103.83	Professional		$43.70	$72.05	$103.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $19.14 / $30.14	Professional	26	$12.22	$19.14	$30.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.32 / $53.10 / $78.36	Professional	TC	$32.32	$53.10	$78.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $93.54 / $380.27	Professional		$62.60	$93.54	$380.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $24.12 / $122.54	Professional	26	$16.75	$24.12	$122.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.93 / $60.53 / $166.01	Professional	TC	$43.93	$60.53	$166.01
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 $63.83 / $64.95 / $70.75	Professional		$63.83	$64.95	$70.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $17.42 / $18.28	Professional	26	$17.19	$17.42	$18.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.59 / $46.41 / $52.46	Professional	TC	$44.59	$46.41	$52.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.12 / $32.34 / $74.01	Professional		$19.12	$32.34	$74.01
United Facility/Professional Professional Modifier Low / Median / High Price $46.30 / $63.91 / $101.59	Professional		$46.30	$63.91	$101.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $17.98 / $33.54	Professional	26	$13.52	$17.98	$33.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.07 / $48.97 / $78.20	Professional	TC	$35.07	$48.97	$78.20