Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.38 / $4.93 / $8.22	Facility	26	$3.38	$4.93	$8.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $39.51 / $163.83	Professional		$23.59	$39.51	$163.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.99 / $4.93 / $15.90	Professional	26	$2.99	$4.93	$15.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.33 / $13.45 / $18.88	Professional	52	$11.33	$13.45	$18.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $33.19 / $82.00	Professional	TC	$20.35	$33.19	$82.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $20.74 / $24.72	Professional		$19.57	$20.74	$24.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $3.55 / $4.00	Professional	26	$3.09	$3.55	$4.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.47 / $27.00 / $27.00	Professional	TC	$21.47	$27.00	$27.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.26 / $22.47 / $44.73	Professional		$3.26	$22.47	$44.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.96 / $34.36 / $146.34	Professional		$22.96	$34.36	$146.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $4.46 / $6.74	Professional	26	$3.16	$4.46	$6.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $29.87 / $141.33	Professional	TC	$20.50	$29.87	$141.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.72 / $36.47 / $366.43	Professional		$24.72	$36.47	$366.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.25 / $4.90 / $57.31	Professional	26	$3.25	$4.90	$57.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.47 / $31.34 / $259.93	Professional	TC	$21.47	$31.34	$259.93
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 $26.34 / $27.50 / $29.21	Professional		$26.34	$27.50	$29.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.71 / $3.74 / $3.82	Professional	26	$3.71	$3.74	$3.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.63 / $23.74 / $25.38	Professional	TC	$22.63	$23.74	$25.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.41 / $21.11 / $33.71	Professional		$4.41	$21.11	$33.71
United Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $39.52 / $112.60	Professional		$24.86	$39.52	$112.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.14 / $4.62 / $7.17	Professional	26	$3.14	$4.62	$7.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $32.47 / $69.84	Professional	TC	$20.97	$32.47	$69.84