Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $27.10 / $34.44	Facility	26	$13.91	$27.10	$34.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.21 / $39.95 / $93.30	Facility	TC	$30.21	$39.95	$93.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $44.12 / $76.59	Professional		$37.58	$44.12	$76.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $15.17 / $27.96	Professional	26	$12.97	$15.17	$27.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.55 / $47.07	Professional	TC	$23.51	$28.55	$47.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $43.38 / $45.95	Professional		$43.38	$43.38	$45.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $12.92 / $24.33	Professional	26	$11.01	$12.92	$24.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.42 / $53.14 / $101.87	Professional		$18.42	$53.14	$101.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $58.65 / $85.77	Professional		$36.57	$58.65	$85.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $20.22 / $31.64	Professional	26	$12.50	$20.22	$31.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.95 / $37.88 / $58.15	Professional	TC	$23.95	$37.88	$58.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $79.25 / $254.18	Professional		$53.04	$79.25	$254.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $25.22 / $117.53	Professional	26	$17.51	$25.22	$117.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.21 / $46.65 / $107.63	Professional	TC	$34.21	$46.65	$107.63
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 $54.08 / $55.17 / $59.57	Professional		$54.08	$55.17	$59.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $18.21 / $19.14	Professional	26	$18.01	$18.21	$19.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $35.86 / $40.43	Professional	TC	$34.36	$35.86	$40.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.02 / $32.34 / $62.32	Professional		$20.02	$32.34	$62.32
United Facility/Professional Professional Modifier Low / Median / High Price $41.94 / $54.72 / $85.13	Professional		$41.94	$54.72	$85.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $19.66 / $30.33	Professional	26	$15.77	$19.66	$30.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $34.54 / $56.11	Professional	TC	$25.70	$34.54	$56.11