Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.01 / $28.59 / $55.25	Facility	26	$20.01	$28.59	$55.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $76.02 / $250.00	Professional		$51.89	$76.02	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $28.55 / $81.79	Professional	26	$17.32	$28.55	$81.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.18 / $45.64 / $94.20	Professional	TC	$33.18	$45.64	$94.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $44.59 / $55.09	Professional		$42.79	$44.59	$55.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $20.80 / $23.40	Professional	26	$18.14	$20.80	$23.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.22 / $50.61 / $100.76	Professional		$19.22	$50.61	$100.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.65 / $75.12 / $124.74	Professional		$50.65	$75.12	$124.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $25.15 / $37.83	Professional	26	$18.23	$25.15	$37.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.21 / $49.13 / $86.45	Professional	TC	$34.21	$49.13	$86.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $80.13 / $344.50	Professional		$55.09	$80.13	$344.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $27.31 / $99.89	Professional	26	$19.05	$27.31	$99.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.03 / $52.12 / $242.93	Professional	TC	$36.03	$52.12	$242.93
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 $59.33 / $60.53 / $65.09	Professional		$59.33	$60.53	$65.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $21.54 / $22.53	Professional	26	$21.35	$21.54	$22.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.78 / $39.17 / $42.58	Professional	TC	$37.78	$39.17	$42.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $32.34 / $68.11	Professional		$23.57	$32.34	$68.11
United Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $84.18 / $134.16	Professional		$53.99	$84.18	$134.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $26.00 / $40.11	Professional	26	$18.39	$26.00	$40.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $53.59 / $91.09	Professional	TC	$34.14	$53.59	$91.09