Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.86 / $11.58 / $13.66	Facility	26	$6.86	$11.58	$13.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $34.40 / $87.50	Professional		$23.03	$34.40	$87.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.86 / $9.17 / $39.78	Professional	26	$6.86	$9.17	$39.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.64 / $137.36 / $137.36	Professional	50	$91.64	$137.36	$137.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.04 / $14.06 / $22.61	Professional	52	$11.04	$14.06	$22.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $21.17 / $40.31	Professional	TC	$17.44	$21.17	$40.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.96 / $25.47 / $28.55	Professional		$16.96	$25.47	$28.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $7.12 / $10.98	Professional	26	$5.58	$7.12	$10.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $21.84 / $28.38	Professional	TC	$21.84	$21.84	$28.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.82 / $33.00 / $63.26	Professional		$9.82	$33.00	$63.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.46 / $37.85 / $55.03	Professional		$23.46	$37.85	$55.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $10.60 / $16.37	Professional	26	$6.52	$10.60	$16.37
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $39.76	Professional	50	$35.13	$35.13	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $26.87 / $39.11	Professional	TC	$16.75	$26.87	$39.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $46.98 / $128.41	Professional		$32.54	$46.98	$128.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $13.30 / $51.37	Professional	26	$9.42	$13.30	$51.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.92 / $33.19 / $73.84	Professional	TC	$22.92	$33.19	$73.84
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 $33.58 / $33.97 / $37.29	Professional		$33.58	$33.97	$37.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $9.61 / $10.21	Professional	26	$9.27	$9.61	$10.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.97 / $24.69 / $27.09	Professional	TC	$23.97	$24.69	$27.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.68 / $32.34 / $39.02	Professional		$10.68	$32.34	$39.02
United Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $34.78 / $57.02	Professional		$26.80	$34.78	$57.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.50 / $15.42	Professional	26	$7.90	$10.50	$15.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $24.53 / $39.44	Professional	TC	$18.61	$24.53	$39.44