Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $25.70 / $33.88	Facility	26	$16.98	$25.70	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $120.23	Professional		$40.74	$57.54	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.88 / $43.65	Professional	26	$16.98	$21.88	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $32.36 / $60.26	Professional	TC	$16.60	$32.36	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $42.66 / $54.95	Professional		$34.67	$42.66	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $19.50	Professional	26	$16.22	$16.22	$19.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $45.71 / $97.72	Professional		$19.05	$45.71	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $95.50	Professional		$44.67	$61.66	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.30 / $45.71	Professional	26	$18.20	$26.30	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $35.48 / $56.23	Professional	TC	$19.05	$35.48	$56.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $77.62 / $288.40	Professional		$45.71	$77.62	$288.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.92 / $85.11	Professional	26	$17.38	$26.92	$85.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.90 / $77.62	Professional	TC	$27.54	$38.90	$77.62
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 $57.54 / $57.54 / $63.10	Professional		$57.54	$57.54	$63.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $22.39	Professional	26	$21.38	$21.38	$22.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $35.48 / $39.81	Professional	TC	$33.88	$35.48	$39.81
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 $36.31 / $51.29 / $79.43	Professional		$36.31	$51.29	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.12 / $40.74	Professional	26	$17.38	$25.12	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $26.30 / $43.65	Professional	TC	$15.14	$26.30	$43.65