Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $32.36 / $60.26	Facility	26	$21.38	$32.36	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $41.69 / $104.71	Professional		$30.90	$41.69	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $29.51 / $89.13	Professional	26	$20.42	$29.51	$89.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	52	$33.11	$33.11	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.02 / $27.54	Professional	TC	$10.00	$12.02	$27.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $42.66	Professional		$26.92	$33.11	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $30.90	Professional	26	$18.62	$22.91	$30.90
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.91 / $8.91 / $8.91	Professional	52	$8.91	$8.91	$8.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.90 / $58.88	Professional		$24.55	$38.90	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $72.44	Professional		$33.88	$46.77	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.20 / $47.86	Professional	26	$22.39	$30.20	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $16.22 / $23.99	Professional	TC	$11.22	$16.22	$23.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $75.86 / $204.17	Professional		$34.67	$75.86	$204.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $29.51 / $123.03	Professional	26	$20.42	$29.51	$123.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $16.98 / $85.11	Professional	TC	$11.48	$16.98	$85.11
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 $41.69 / $41.69 / $45.71	Professional		$41.69	$41.69	$45.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $26.30 / $28.18	Professional	26	$23.99	$26.30	$28.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.79 / $16.60	Professional	TC	$14.13	$14.79	$16.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $41.69 / $63.10	Professional		$30.90	$41.69	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $42.66	Professional	26	$20.42	$27.54	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $13.49 / $20.89	Professional	TC	$9.77	$13.49	$20.89