Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.64 / $29.59 / $40.65	Facility	26	$16.64	$29.59	$40.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $63.49 / $176.12	Professional		$51.98	$63.49	$176.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $18.82 / $59.18	Professional	26	$16.32	$18.82	$59.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $200.26 / $200.26 / $200.26	Professional	50	$200.26	$200.26	$200.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.85 / $30.84 / $41.77	Professional	52	$24.85	$30.84	$41.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $43.50 / $64.33	Professional	TC	$35.60	$43.50	$64.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.44 / $81.20 / $85.65	Professional		$69.44	$81.20	$85.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.61 / $23.75 / $26.46	Professional	26	$21.61	$23.75	$26.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $51.42 / $90.95	Professional		$19.97	$51.42	$90.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.65 / $20.65 / $20.65	Facility	26	$20.65	$20.65	$20.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.89 / $82.52 / $132.22	Professional		$59.89	$82.52	$132.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.68 / $25.51 / $40.24	Professional	26	$18.68	$25.51	$40.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.93 / $57.08 / $94.60	Professional	TC	$40.93	$57.08	$94.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $90.64 / $243.92	Professional		$59.35	$90.64	$243.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $27.02 / $100.91	Professional	26	$18.01	$27.02	$100.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.57 / $57.90 / $108.82	Professional	TC	$40.57	$57.90	$108.82
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 $70.14 / $72.40 / $77.18	Professional		$70.14	$72.40	$77.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.10 / $22.20 / $23.41	Professional	26	$22.10	$22.20	$23.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.70 / $47.94 / $53.77	Professional	TC	$45.70	$47.94	$53.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $32.34 / $75.53	Professional		$23.91	$32.34	$75.53
United Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $80.55 / $129.19	Professional		$53.04	$80.55	$129.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $26.43 / $41.57	Professional	26	$16.91	$26.43	$41.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.84 / $56.54 / $90.61	Professional	TC	$38.84	$56.54	$90.61