Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.45 / $19.79 / $19.79	Facility	26	$12.45	$19.79	$19.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $41.18 / $62.43	Professional		$36.19	$41.18	$62.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $12.45 / $17.36	Professional	26	$11.14	$12.45	$17.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $29.46 / $42.36	Professional	TC	$24.92	$29.46	$42.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $41.11 / $41.11	Professional		$41.11	$41.11	$41.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.42 / $41.96 / $86.48	Professional		$13.42	$41.96	$86.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.26 / $58.78 / $85.30	Professional		$42.26	$58.78	$85.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $16.72 / $26.54	Professional	26	$12.28	$16.72	$26.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.26 / $41.56 / $59.34	Professional	TC	$29.26	$41.56	$59.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $66.22 / $134.34	Professional		$44.31	$66.22	$134.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $16.94 / $49.93	Professional	26	$12.10	$16.94	$49.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.80 / $43.77 / $79.95	Professional	TC	$30.80	$43.77	$79.95
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 $52.36 / $53.47 / $57.88	Professional		$52.36	$53.47	$57.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $14.69 / $15.73	Professional	26	$13.37	$14.69	$15.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.82 / $37.40 / $42.15	Professional	TC	$35.82	$37.40	$42.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.46 / $32.34 / $60.55	Professional		$16.46	$32.34	$60.55
United Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $51.84 / $82.47	Professional		$37.89	$51.84	$82.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $15.59 / $25.61	Professional	26	$11.62	$15.59	$25.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $36.10 / $56.84	Professional	TC	$25.66	$36.10	$56.84