Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $40.74 / $74.13	Facility	26	$21.88	$40.74	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $69.18 / $194.98	Professional		$34.67	$69.18	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $36.31 / $97.72	Professional	26	$22.39	$36.31	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $25.70 / $79.43	Professional	TC	$12.02	$25.70	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $46.77	Professional		$30.90	$30.90	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.99 / $29.51	Professional	26	$17.78	$23.99	$29.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $56.23 / $93.33	Professional		$30.20	$56.23	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $128.82	Professional		$42.66	$72.44	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $51.29	Professional	26	$23.44	$33.88	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $30.90 / $81.28	Professional	TC	$16.60	$30.90	$81.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $97.72 / $346.74	Professional		$43.65	$97.72	$346.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $40.74 / $223.87	Professional	26	$25.70	$40.74	$223.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $30.20 / $173.78	Professional	TC	$17.38	$30.20	$173.78
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 $48.98 / $48.98 / $53.70	Professional		$48.98	$48.98	$53.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $31.62	Professional	26	$29.51	$29.51	$31.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $20.42 / $22.39	Professional	TC	$19.95	$20.42	$22.39
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 $47.86 / $83.18 / $117.49	Professional		$47.86	$83.18	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $45.71	Professional	26	$24.55	$32.36	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $75.86	Professional	TC	$23.99	$44.67	$75.86