Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.55 / $35.82 / $39.11	Facility	26	$21.55	$35.82	$39.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.42 / $36.24 / $71.30	Professional		$30.42	$36.24	$71.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $23.86 / $52.25	Professional	26	$20.30	$23.86	$52.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.15 / $17.17 / $23.08	Professional	52	$15.15	$17.17	$23.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.18 / $12.31 / $17.61	Professional	TC	$10.18	$12.31	$17.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $34.92 / $46.98	Professional		$28.50	$34.92	$46.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.71 / $25.01 / $34.43	Professional	26	$19.71	$25.01	$34.43
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.19 / $8.19 / $8.19	Professional	52	$8.19	$8.19	$8.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.29 / $38.59 / $61.32	Professional		$24.29	$38.59	$61.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.82 / $46.98 / $71.83	Professional		$33.82	$46.98	$71.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $29.95 / $47.93	Professional	26	$22.18	$29.95	$47.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.52 / $16.43 / $23.34	Professional	TC	$11.52	$16.43	$23.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $51.54 / $201.37	Professional		$35.25	$51.54	$201.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.90 / $30.66 / $116.51	Professional	26	$21.90	$30.66	$116.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.17 / $17.34 / $73.38	Professional	TC	$12.17	$17.34	$73.38
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 $41.52 / $41.87 / $45.24	Professional		$41.52	$41.87	$45.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $26.49 / $28.47	Professional	26	$24.20	$26.49	$28.47
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.25 / $14.77 / $16.77	Professional	TC	$14.25	$14.77	$16.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $32.34 / $47.33	Professional		$17.54	$32.34	$47.33
United Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $41.84 / $66.70	Professional		$31.13	$41.84	$66.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.80 / $27.49 / $45.97	Professional	26	$20.80	$27.49	$45.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.83 / $13.71 / $21.31	Professional	TC	$9.83	$13.71	$21.31