Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.72 / $13.38 / $14.21	Facility	26	$7.72	$13.38	$14.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.44 / $31.42 / $71.86	Facility	TC	$20.44	$31.42	$71.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.16 / $47.87	Professional		$21.88	$28.16	$47.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $7.91 / $15.95	Professional	26	$7.06	$7.91	$15.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.04 / $20.44 / $35.83	Professional	TC	$17.04	$20.44	$35.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $22.17 / $22.17	Professional		$22.17	$22.17	$22.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $9.82 / $11.35	Professional	26	$6.09	$9.82	$11.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $34.51 / $66.15	Professional		$10.24	$34.51	$66.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $38.74 / $57.27	Professional		$23.41	$38.74	$57.27
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 TC Low / Median / High Price $16.79 / $27.58 / $40.82	Professional	TC	$16.79	$27.58	$40.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $51.45 / $140.94	Professional		$34.44	$51.45	$140.94
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $12.30 / $39.97	Professional	26	$9.00	$12.30	$39.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $32.75 / $77.39	Professional	TC	$24.01	$32.75	$77.39
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 $35.11 / $35.58 / $39.01	Professional		$35.11	$35.58	$39.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $9.69 / $10.63	Professional	26	$9.03	$9.69	$10.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $25.13 / $28.38	Professional	TC	$24.12	$25.13	$28.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $32.34 / $40.81	Professional		$11.12	$32.34	$40.81
United Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $35.15 / $55.86	Professional		$26.89	$35.15	$55.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $10.51 / $16.07	Professional	26	$8.43	$10.51	$16.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.89 / $25.70 / $40.24	Professional	TC	$18.89	$25.70	$40.24