Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $23.58 / $30.63	Facility	26	$12.36	$23.58	$30.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.00 / $38.84 / $89.60	Facility	TC	$28.00	$38.84	$89.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $40.36 / $72.73	Professional		$35.39	$40.36	$72.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $13.17 / $24.92	Professional	26	$11.49	$13.17	$24.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $27.56 / $46.43	Professional	TC	$22.85	$27.56	$46.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $30.38 / $39.88	Professional		$30.38	$30.38	$39.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $11.44 / $13.74	Professional	26	$9.74	$11.44	$13.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.38 / $42.07 / $93.65	Professional		$16.38	$42.07	$93.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.76 / $54.01 / $79.86	Professional		$33.76	$54.01	$79.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $17.67 / $27.66	Professional	26	$11.07	$17.67	$27.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $36.39 / $54.44	Professional	TC	$22.65	$36.39	$54.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.76 / $72.84 / $236.16	Professional		$48.76	$72.84	$236.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $19.89 / $73.51	Professional	26	$14.40	$19.89	$73.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.02 / $43.67 / $121.75	Professional	TC	$32.02	$43.67	$121.75
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 $49.71 / $50.66 / $54.86	Professional		$49.71	$50.66	$54.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $15.93 / $17.02	Professional	26	$14.46	$15.93	$17.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.17 / $33.57 / $37.84	Professional	TC	$32.17	$33.57	$37.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $32.34 / $57.39	Professional		$17.80	$32.34	$57.39
United Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $50.17 / $77.12	Professional		$37.95	$50.17	$77.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.03 / $19.22 / $35.22	Professional	26	$14.03	$19.22	$35.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $33.35 / $52.26	Professional	TC	$25.02	$33.35	$52.26