Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.27 / $19.27 / $30.54	Facility	26	$19.27	$19.27	$30.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.81 / $72.84 / $182.26	Professional		$64.81	$72.84	$182.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $21.20 / $45.41	Professional	26	$17.82	$21.20	$45.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $53.90 / $95.34	Professional	TC	$44.67	$53.90	$95.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $68.26 / $97.63	Professional		$68.26	$68.26	$97.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $20.83 / $25.15	Professional	26	$18.86	$20.83	$25.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $90.72 / $167.82	Professional		$27.74	$90.72	$167.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.80 / $83.80 / $233.80	Professional		$59.80	$83.80	$233.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $25.61 / $179.60	Professional	26	$17.82	$25.61	$179.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.68 / $60.41 / $179.60	Professional	TC	$46.68	$60.41	$179.60
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 $89.09 / $91.26 / $98.64	Professional		$89.09	$91.26	$98.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.13 / $25.61 / $27.25	Professional	26	$25.13	$25.61	$27.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.48 / $66.13 / $71.40	Professional	TC	$63.48	$66.13	$71.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $32.34 / $103.20	Professional		$27.58	$32.34	$103.20
United Facility/Professional Professional Modifier Low / Median / High Price $77.65 / $104.97 / $182.25	Professional		$77.65	$104.97	$182.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.86 / $24.92 / $41.46	Professional	26	$19.86	$24.92	$41.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.58 / $82.08 / $138.51	Professional	TC	$55.58	$82.08	$138.51