Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.87 / $40.40 / $47.28	Facility	26	$28.87	$40.40	$47.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.10 / $52.33 / $139.41	Professional		$41.10	$52.33	$139.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $29.30 / $62.95	Professional	26	$25.82	$29.30	$62.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.25 / $23.83 / $37.10	Professional	TC	$18.25	$23.83	$37.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.76 / $34.75 / $68.39	Professional		$26.76	$34.75	$68.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $34.21 / $38.85	Professional	26	$21.63	$34.21	$38.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $45.11 / $66.70	Professional		$36.06	$45.11	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.09 / $61.65 / $179.64	Professional		$41.09	$61.65	$179.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.44 / $37.40 / $164.07	Professional	26	$26.44	$37.40	$164.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.87 / $20.37 / $164.07	Professional	TC	$13.87	$20.37	$164.07
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 $53.42 / $53.43 / $57.63	Professional		$53.42	$53.43	$57.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $35.40 / $37.40	Professional	26	$34.50	$35.40	$37.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $18.92 / $20.22	Professional	TC	$18.03	$18.92	$20.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $32.34 / $60.29	Professional		$21.15	$32.34	$60.29
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.66 / $102.02	Professional		$54.95	$70.66	$102.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.54 / $39.22 / $56.58	Professional	26	$30.54	$39.22	$56.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $31.89 / $45.65	Professional	TC	$23.17	$31.89	$45.65