Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.94 / $14.07 / $21.30	Facility	26	$9.94	$14.07	$21.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $62.60 / $169.07	Professional		$35.90	$62.60	$169.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $14.16 / $39.94	Professional	26	$9.68	$14.16	$39.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $37.78 / $69.12	Professional	TC	$26.13	$37.78	$69.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $36.15 / $47.73	Professional		$32.00	$36.15	$47.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.65 / $14.17	Professional	26	$8.73	$10.65	$14.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $25.81 / $37.04	Professional	TC	$23.48	$25.81	$37.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.24 / $33.40 / $68.08	Professional		$11.24	$33.40	$68.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $63.21 / $111.32	Professional		$39.54	$63.21	$111.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.59 / $15.41 / $27.56	Professional	26	$10.59	$15.41	$27.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $46.78 / $82.87	Professional	TC	$28.87	$46.78	$82.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $60.25 / $223.97	Professional		$38.97	$60.25	$223.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $15.51 / $92.50	Professional	26	$10.38	$15.51	$92.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.40 / $41.31 / $162.33	Professional	TC	$28.40	$41.31	$162.33
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 $46.07 / $46.96 / $51.03	Professional		$46.07	$46.96	$51.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.21 / $12.52 / $13.18	Professional	26	$12.21	$12.52	$13.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.57 / $34.75 / $37.84	Professional	TC	$33.57	$34.75	$37.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.79 / $32.34 / $53.38	Professional		$13.79	$32.34	$53.38
United Facility/Professional Professional Modifier Low / Median / High Price $50.38 / $68.05 / $112.52	Professional		$50.38	$68.05	$112.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $16.02 / $26.13	Professional	26	$11.77	$16.02	$26.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.94 / $52.17 / $87.00	Professional	TC	$38.94	$52.17	$87.00