Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $23.44 / $39.81	Facility	26	$12.02	$23.44	$39.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $53.70 / $147.91	Facility	TC	$28.84	$53.70	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $158.49	Professional		$37.15	$52.48	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $66.07	Professional	26	$10.96	$20.89	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $66.07	Professional	TC	$25.12	$33.11	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $32.36 / $37.15	Professional		$28.18	$32.36	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $19.05	Professional	26	$10.23	$10.23	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $35.48	Professional	TC	$18.62	$23.44	$35.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $43.65 / $100.00	Professional		$16.98	$43.65	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $87.10	Professional		$38.02	$60.26	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.95 / $31.62	Professional	26	$12.02	$19.95	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $60.26	Professional	TC	$25.70	$40.74	$60.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $100.00 / $251.19	Professional		$53.70	$100.00	$251.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $28.84 / $97.72	Professional	26	$16.22	$28.84	$97.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $57.54 / $169.82	Professional	TC	$36.31	$57.54	$169.82
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $58.88	Professional		$52.48	$53.70	$58.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.60 / $17.38	Professional	26	$16.22	$16.60	$17.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $37.15 / $40.74	Professional	TC	$36.31	$37.15	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $81.28	Professional		$42.66	$56.23	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $28.18	Professional	26	$14.13	$18.62	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $36.31 / $53.70	Professional	TC	$28.18	$36.31	$53.70