Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $31.62 / $33.88	Facility	26	$18.20	$31.62	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $190.55	Professional		$30.20	$47.86	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $25.12 / $102.33	Professional	26	$16.98	$25.12	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $17.78 / $97.72	Professional	TC	$12.88	$17.78	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $35.48 / $38.02	Professional		$34.67	$35.48	$38.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $39.81 / $58.88	Professional		$23.44	$39.81	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $61.66 / $173.78	Professional		$36.31	$61.66	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $32.36 / $56.23	Professional	26	$19.95	$32.36	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.92 / $123.03	Professional	TC	$15.85	$26.92	$123.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $154.88 / $288.40	Professional		$46.77	$154.88	$288.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $50.12 / $229.09	Professional	26	$24.55	$50.12	$229.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $31.62 / $123.03	Professional	TC	$19.50	$31.62	$123.03
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 / $46.77 / $50.12	Professional		$46.77	$46.77	$50.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $27.54	Professional	26	$25.70	$25.70	$27.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.89 / $23.44	Professional	TC	$20.42	$20.89	$23.44
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 $38.90 / $60.26 / $173.78	Professional		$38.90	$60.26	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $31.62 / $54.95	Professional	26	$21.38	$31.62	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.70 / $120.23	Professional	TC	$16.22	$25.70	$120.23