Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.14 / $10.76 / $14.21	Facility	26	$7.14	$10.76	$14.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $36.65 / $108.65	Professional		$20.35	$36.65	$108.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.63 / $42.40	Professional	26	$7.03	$10.63	$42.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.72 / $102.21 / $110.13	Professional	50	$99.72	$102.21	$110.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.28 / $46.52	Professional	TC	$18.82	$23.28	$46.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $24.19 / $31.82	Professional		$19.48	$24.19	$31.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $8.18 / $11.04	Professional	26	$5.82	$8.18	$11.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.09 / $26.09 / $26.09	Professional	TC	$26.09	$26.09	$26.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $37.90 / $66.67	Professional		$10.24	$37.90	$66.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $40.47 / $61.69	Professional		$25.20	$40.47	$61.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $11.04 / $17.07	Professional	26	$6.80	$11.04	$17.07
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $42.89	Professional	50	$37.85	$37.85	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.67 / $29.77 / $46.39	Professional	TC	$18.67	$29.77	$46.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $53.41 / $159.61	Professional		$36.29	$53.41	$159.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $13.84 / $62.54	Professional	26	$9.69	$13.84	$62.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $37.36 / $112.07	Professional	TC	$27.14	$37.36	$112.07
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 $38.57 / $39.20 / $42.89	Professional		$38.57	$39.20	$42.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $10.00 / $10.63	Professional	26	$9.69	$10.00	$10.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $29.51 / $32.25	Professional	TC	$28.57	$29.51	$32.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $32.34 / $44.87	Professional		$11.12	$32.34	$44.87
United Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $37.45 / $58.85	Professional		$28.42	$37.45	$58.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $10.44 / $16.23	Professional	26	$8.21	$10.44	$16.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $29.03 / $51.83	Professional	TC	$20.23	$29.03	$51.83