Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.80 / $44.77 / $48.77	Facility	26	$26.80	$44.77	$48.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $63.95 / $122.89	Professional		$56.32	$63.95	$122.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $29.86 / $65.65	Professional	26	$25.30	$29.86	$65.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.81 / $34.64 / $50.31	Professional	TC	$29.81	$34.64	$50.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $52.64 / $54.25	Professional		$52.64	$52.64	$54.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.57 / $30.81 / $38.86	Professional	26	$23.57	$30.81	$38.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.09 / $60.19 / $109.22	Professional		$30.09	$60.19	$109.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.24 / $89.39 / $193.04	Professional		$61.24	$89.39	$193.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $37.85 / $61.15	Professional	26	$27.65	$37.85	$61.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $49.56 / $131.44	Professional	TC	$32.86	$49.56	$131.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $93.89 / $284.60	Professional		$64.20	$93.89	$284.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.68 / $179.68	Professional	26	$28.18	$39.68	$179.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.71 / $51.39 / $190.89	Professional	TC	$35.71	$51.39	$190.89
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 $75.87 / $76.48 / $83.01	Professional		$75.87	$76.48	$83.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $33.68 / $35.28	Professional	26	$33.15	$33.68	$35.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.20 / $43.34 / $47.72	Professional	TC	$42.20	$43.34	$47.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $33.38 / $86.84	Professional		$32.34	$33.38	$86.84
United Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $73.39 / $123.98	Professional		$53.47	$73.39	$123.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $34.02 / $56.16	Professional	26	$26.12	$34.02	$56.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.70 / $37.21 / $58.41	Professional	TC	$27.70	$37.21	$58.41