Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.27 / $13.58 / $15.97	Facility	26	$8.27	$13.58	$15.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.96 / $35.35 / $360.32	Facility	TC	$22.96	$35.35	$360.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.14 / $31.61 / $59.54	Professional		$21.14	$31.61	$59.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $9.44 / $35.20	Professional	26	$8.02	$9.44	$35.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $22.55 / $37.21	Professional	TC	$18.32	$22.55	$37.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.89 / $33.67 / $42.95	Professional		$19.89	$33.67	$42.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.79 / $12.84	Professional	26	$6.61	$7.79	$12.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.47 / $38.72 / $74.23	Professional		$11.47	$38.72	$74.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $41.71 / $62.91	Professional		$25.94	$41.71	$62.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $12.37 / $19.21	Professional	26	$7.65	$12.37	$19.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.52 / $29.45 / $45.77	Professional	TC	$18.52	$29.45	$45.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $57.76 / $161.12	Professional		$38.65	$57.76	$161.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $15.57 / $62.67	Professional	26	$10.79	$15.57	$62.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.93 / $36.72 / $89.86	Professional	TC	$26.93	$36.72	$89.86
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 $39.42 / $40.04 / $43.73	Professional		$39.42	$40.04	$43.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $11.22 / $11.91	Professional	26	$10.93	$11.22	$11.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $28.20 / $31.82	Professional	TC	$27.05	$28.20	$31.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.46 / $32.34 / $45.75	Professional		$12.46	$32.34	$45.75
United Facility/Professional Professional Modifier Low / Median / High Price $29.81 / $37.86 / $57.82	Professional		$29.81	$37.86	$57.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $11.86 / $18.80	Professional	26	$9.47	$11.86	$18.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $26.68 / $43.61	Professional	TC	$20.07	$26.68	$43.61