Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $15.49 / $27.54	Facility	26	$7.94	$15.49	$27.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $41.69 / $363.08	Facility	TC	$21.88	$41.69	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $36.31 / $117.49	Professional		$17.38	$36.31	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $37.15	Professional	26	$7.94	$12.88	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $46.77	Professional	TC	$18.20	$23.99	$46.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.20 / $36.31	Professional		$20.89	$30.20	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.71 / $14.45	Professional	26	$6.61	$8.71	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	TC	$30.90	$30.90	$30.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $38.90 / $74.13	Professional		$11.48	$38.90	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $39.81 / $60.26	Professional		$26.30	$39.81	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.30 / $18.62	Professional	26	$7.76	$12.30	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $43.65	Professional	TC	$18.62	$28.18	$43.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $97.72 / $199.53	Professional		$39.81	$97.72	$199.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $22.91 / $100.00	Professional	26	$10.72	$22.91	$100.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $36.31 / $114.82	Professional	TC	$26.30	$36.31	$114.82
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 $39.81 / $39.81 / $43.65	Professional		$39.81	$39.81	$43.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $12.02	Professional	26	$10.96	$11.22	$12.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.18 / $31.62	Professional	TC	$26.92	$28.18	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $54.95	Professional		$28.84	$37.15	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $11.48 / $17.38	Professional	26	$9.12	$11.48	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $38.02	Professional	TC	$19.05	$25.70	$38.02