Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.10 / $17.63 / $31.48	Facility	26	$12.10	$17.63	$31.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.82 / $45.00 / $69.75	Professional		$39.82	$45.00	$69.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $12.48 / $19.62	Professional	26	$10.90	$12.48	$19.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.03 / $32.89 / $48.42	Professional	TC	$28.03	$32.89	$48.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $38.22 / $44.20	Professional		$36.97	$38.22	$44.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $12.36 / $16.47	Professional	26	$10.30	$12.36	$16.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $29.68 / $37.10	Professional	TC	$27.01	$29.68	$37.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $38.52 / $77.28	Professional		$13.05	$38.52	$77.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $60.28 / $86.41	Professional		$43.24	$60.28	$86.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.99 / $16.36 / $25.82	Professional	26	$11.99	$16.36	$25.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.39 / $43.44 / $62.48	Professional	TC	$31.39	$43.44	$62.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $65.39 / $147.60	Professional		$44.96	$65.39	$147.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $17.39 / $64.20	Professional	26	$12.01	$17.39	$64.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $46.62 / $92.50	Professional	TC	$32.61	$46.62	$92.50
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 $53.13 / $54.28 / $58.73	Professional		$53.13	$54.28	$58.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $14.59 / $15.30	Professional	26	$14.29	$14.59	$15.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $39.97 / $43.43	Professional	TC	$38.54	$39.97	$43.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.01 / $32.34 / $61.44	Professional		$16.01	$32.34	$61.44
United Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $53.24 / $86.31	Professional		$39.43	$53.24	$86.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $15.12 / $24.75	Professional	26	$11.32	$15.12	$24.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.74 / $38.11 / $62.78	Professional	TC	$27.74	$38.11	$62.78