Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $11.48 / $12.88	Facility	26	$7.59	$11.48	$12.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $45.71 / $147.91	Professional		$25.12	$45.71	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.48 / $33.11	Professional	26	$6.61	$11.48	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.39 / $45.71	Professional	TC	$16.60	$22.39	$45.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $24.55 / $57.54	Professional		$19.05	$24.55	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $8.51 / $12.88	Professional	26	$5.62	$8.51	$12.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $25.12 / $48.98	Professional		$7.94	$25.12	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $70.79	Professional		$24.55	$37.15	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.23 / $16.22	Professional	26	$7.41	$10.23	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $53.70	Professional	TC	$18.62	$26.92	$53.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $60.26 / $251.19	Professional		$26.92	$60.26	$251.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $61.66	Professional	26	$7.94	$12.30	$61.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $35.48 / $208.93	Professional	TC	$19.05	$35.48	$208.93
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 $28.84 / $29.51 / $32.36	Professional		$28.84	$29.51	$32.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $8.71 / $9.33	Professional	26	$8.51	$8.71	$9.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $21.38 / $22.91	Professional	TC	$20.42	$21.38	$22.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $22.91 / $33.11	Professional		$11.48	$22.91	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $66.07	Professional		$25.70	$37.15	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.55 / $14.79	Professional	26	$7.24	$9.55	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $50.12	Professional	TC	$18.20	$25.70	$50.12