Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.68 / $22.04 / $29.63	Facility	26	$12.68	$22.04	$29.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.89 / $46.17 / $259.89	Facility	TC	$29.89	$46.17	$259.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.82 / $47.25 / $85.19	Professional		$37.82	$47.25	$85.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $15.33 / $32.38	Professional	26	$11.86	$15.33	$32.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.97 / $31.92 / $54.21	Professional	TC	$25.97	$31.92	$54.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.54 / $32.28 / $36.86	Professional		$26.54	$32.28	$36.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $13.41 / $17.46	Professional	26	$10.18	$13.41	$17.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $51.90 / $99.50	Professional		$16.79	$51.90	$99.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.24 / $60.95 / $93.97	Professional		$38.24	$60.95	$93.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $19.55 / $31.87	Professional	26	$12.03	$19.55	$31.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.81 / $41.82 / $61.23	Professional	TC	$25.81	$41.82	$61.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.80 / $76.23 / $219.53	Professional		$51.80	$76.23	$219.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $23.47 / $86.50	Professional	26	$16.26	$23.47	$86.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.54 / $52.24 / $135.83	Professional	TC	$35.54	$52.24	$135.83
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 $52.82 / $53.90 / $58.29	Professional		$52.82	$53.90	$58.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $16.57 / $17.43	Professional	26	$16.34	$16.57	$17.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.24 / $37.57 / $40.86	Professional	TC	$36.24	$37.57	$40.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.23 / $32.34 / $60.98	Professional		$18.23	$32.34	$60.98
United Facility/Professional Professional Modifier Low / Median / High Price $44.12 / $58.18 / $86.65	Professional		$44.12	$58.18	$86.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $19.98 / $31.55	Professional	26	$14.65	$19.98	$31.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.45 / $39.21 / $55.95	Professional	TC	$28.45	$39.21	$55.95