Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $11.07 / $13.61	Facility	26	$6.76	$11.07	$13.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.55 / $22.30 / $84.39	Facility	TC	$13.55	$22.30	$84.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $23.58 / $52.25	Professional		$17.89	$23.58	$52.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.58 / $20.79	Professional	26	$6.42	$7.58	$20.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.94 / $15.72 / $26.68	Professional	TC	$11.94	$15.72	$26.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $20.54 / $21.64	Professional		$15.43	$20.54	$21.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.44 / $7.90 / $10.50	Professional	26	$5.44	$7.90	$10.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.42 / $25.43 / $44.73	Professional		$9.42	$25.43	$44.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $29.97 / $46.27	Professional		$18.89	$29.97	$46.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.23 / $10.16 / $15.69	Professional	26	$6.23	$10.16	$15.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $35.06	Professional	50	$31.05	$31.05	$35.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.65 / $20.32 / $30.16	Professional	TC	$12.65	$20.32	$30.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $37.67 / $123.28	Professional		$25.39	$37.67	$123.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $12.78 / $51.26	Professional	26	$9.01	$12.78	$51.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $23.28 / $80.22	Professional	TC	$16.37	$23.28	$80.22
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 $25.88 / $25.90 / $28.69	Professional		$25.88	$25.90	$28.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $9.19 / $9.77	Professional	26	$8.86	$9.19	$9.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $17.04 / $18.92	Professional	TC	$16.69	$17.04	$18.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $30.02 / $32.34	Professional		$10.23	$30.02	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $29.39 / $42.50	Professional		$21.65	$29.39	$42.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $9.47 / $15.34	Professional	26	$7.55	$9.47	$15.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.71 / $19.14 / $27.16	Professional	TC	$13.71	$19.14	$27.16