Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.77 / $15.57 / $21.89	Facility	26	$10.77	$15.57	$21.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $39.35 / $155.19	Professional		$28.71	$39.35	$155.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.00 / $58.75	Professional	26	$10.23	$14.00	$58.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $22.29 / $35.86	Professional	TC	$18.48	$22.29	$35.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $25.86 / $48.13	Professional		$25.86	$25.86	$48.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $12.56 / $17.12	Professional	26	$8.77	$12.56	$17.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.61 / $30.77 / $79.14	Professional		$11.61	$30.77	$79.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $43.30 / $69.17	Professional		$29.49	$43.30	$69.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $15.84 / $27.32	Professional	26	$10.40	$15.84	$27.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.34 / $27.79 / $43.51	Professional	TC	$19.34	$27.79	$43.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $49.95 / $270.85	Professional		$34.97	$49.95	$270.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $16.75 / $132.57	Professional	26	$12.04	$16.75	$132.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $28.82 / $126.96	Professional	TC	$21.96	$28.82	$126.96
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 $36.08 / $36.47 / $39.85	Professional		$36.08	$36.47	$39.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $12.86 / $13.61	Professional	26	$12.60	$12.86	$13.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $23.21 / $26.23	Professional	TC	$22.30	$23.21	$26.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.24 / $32.34 / $41.68	Professional		$14.24	$32.34	$41.68
United Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $47.79 / $74.95	Professional		$34.10	$47.79	$74.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.30 / $18.30 / $30.13	Professional	26	$13.30	$18.30	$30.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.73 / $28.14 / $50.67	Professional	TC	$20.73	$28.14	$50.67