Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.98 / $13.87 / $14.85	Facility	26	$7.98	$13.87	$14.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $31.30 / $64.95	Professional		$25.85	$31.30	$64.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.88 / $47.50	Professional	26	$7.33	$8.88	$47.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $137.15 / $650.00 / $2,240.00	Professional	50	$137.15	$650.00	$2,240.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.96 / $37.95	Professional	TC	$18.53	$22.96	$37.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $33.32 / $33.32	Professional		$22.17	$33.32	$33.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.00 / $8.74 / $12.39	Professional	26	$6.00	$8.74	$12.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.05 / $38.35 / $73.51	Professional		$11.05	$38.35	$73.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.87 / $38.86 / $60.04	Professional		$24.87	$38.86	$60.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $11.75 / $18.11	Professional	26	$7.16	$11.75	$18.11
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $43.42	Professional	50	$38.29	$38.29	$43.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $29.37 / $45.77	Professional	TC	$17.57	$29.37	$45.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $53.30 / $161.12	Professional		$36.64	$53.30	$161.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $14.99 / $103.90	Professional	26	$10.60	$14.99	$103.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $35.25 / $78.79	Professional	TC	$20.72	$35.25	$78.79
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 $39.03 / $39.64 / $43.30	Professional		$39.03	$39.64	$43.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $10.83 / $11.48	Professional	26	$10.53	$10.83	$11.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.20 / $29.12 / $31.82	Professional	TC	$28.20	$29.12	$31.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $32.34 / $45.30	Professional		$12.01	$32.34	$45.30
United Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $36.65 / $58.19	Professional		$28.10	$36.65	$58.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $11.83 / $21.79	Professional	26	$8.44	$11.83	$21.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $25.93 / $42.12	Professional	TC	$19.35	$25.93	$42.12