Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.51 / $15.56 / $17.75	Facility	26	$9.51	$15.56	$17.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $38.51 / $79.87	Professional		$31.42	$38.51	$79.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $11.52 / $42.50	Professional	26	$8.22	$11.52	$42.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $27.37 / $53.79	Professional	TC	$23.19	$27.37	$53.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $35.29 / $39.75	Professional		$26.40	$35.29	$39.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $11.33 / $14.57	Professional	26	$7.38	$11.33	$14.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $33.15 / $33.85	Professional	TC	$33.15	$33.15	$33.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.51 / $45.69 / $80.38	Professional		$13.51	$45.69	$80.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $49.44 / $74.00	Professional		$30.74	$49.44	$74.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $13.85 / $20.98	Professional	26	$8.61	$13.85	$20.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $36.10 / $53.82	Professional	TC	$22.56	$36.10	$53.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $64.34 / $203.67	Professional		$43.53	$64.34	$203.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $18.02 / $70.06	Professional	26	$12.78	$18.02	$70.06
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $44.91 / $154.71	Professional	TC	$31.56	$44.91	$154.71
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 $46.50 / $47.37 / $51.44	Professional		$46.50	$47.37	$51.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $13.33 / $14.03	Professional	26	$13.03	$13.33	$14.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.18 / $34.35 / $37.40	Professional	TC	$33.18	$34.35	$37.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.67 / $32.34 / $53.82	Professional		$14.67	$32.34	$53.82
United Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $45.82 / $72.54	Professional		$34.61	$45.82	$72.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $13.28 / $22.08	Professional	26	$9.72	$13.28	$22.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.63 / $33.36 / $50.24	Professional	TC	$24.63	$33.36	$50.24