Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $8.91 / $19.50	Facility	26	$5.62	$8.91	$19.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $39.81 / $281.84	Facility	TC	$21.88	$39.81	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $38.90 / $131.83	Professional		$12.88	$38.90	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $10.72 / $30.90	Professional	26	$5.50	$10.72	$30.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $60.26	Professional	TC	$19.05	$29.51	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.39 / $39.81	Professional		$18.20	$22.39	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $5.89 / $9.33	Professional	26	$4.68	$5.89	$9.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $25.70	Professional	TC	$16.98	$22.91	$25.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $33.88 / $64.57	Professional		$8.13	$33.88	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $54.95	Professional		$23.99	$36.31	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $8.91 / $13.18	Professional	26	$5.37	$8.91	$13.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $42.66	Professional	TC	$18.20	$28.18	$42.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $66.07 / $151.36	Professional		$32.36	$66.07	$151.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $66.07	Professional	26	$7.59	$13.18	$66.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $107.15	Professional	TC	$22.91	$36.31	$107.15
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 $33.88 / $34.67 / $38.02	Professional		$33.88	$34.67	$38.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.94 / $8.51	Professional	26	$7.59	$7.94	$8.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $26.92 / $29.51	Professional	TC	$26.30	$26.92	$29.51
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 $25.12 / $33.11 / $48.98	Professional		$25.12	$33.11	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.94 / $12.30	Professional	26	$6.17	$7.94	$12.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $38.02	Professional	TC	$19.05	$25.12	$38.02