Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.68 / $8.58 / $11.31	Facility	26	$5.68	$8.58	$11.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.01 / $34.97 / $396.16	Facility	TC	$22.01	$34.97	$396.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $33.44 / $107.11	Professional		$21.52	$33.44	$107.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $7.58 / $32.29	Professional	26	$5.53	$7.58	$32.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $23.81 / $45.51	Professional	TC	$19.09	$23.81	$45.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $26.11 / $29.38	Professional		$21.45	$26.11	$29.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $5.85 / $9.97	Professional	26	$4.68	$5.85	$9.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.19 / $30.81 / $30.81	Professional	TC	$27.19	$30.81	$30.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.19 / $33.65 / $64.50	Professional		$8.19	$33.65	$64.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $36.95 / $56.79	Professional		$23.86	$36.95	$56.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.38 / $8.83 / $13.53	Professional	26	$5.38	$8.83	$13.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $29.21 / $44.47	Professional	TC	$18.16	$29.21	$44.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.31 / $46.99 / $137.66	Professional		$32.31	$46.99	$137.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $11.12 / $45.31	Professional	26	$7.66	$11.12	$45.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $35.11 / $75.03	Professional	TC	$23.47	$35.11	$75.03
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 $34.24 / $34.72 / $38.18	Professional		$34.24	$34.72	$38.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $7.97 / $8.50	Professional	26	$7.62	$7.97	$8.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $27.11 / $29.67	Professional	TC	$26.27	$27.11	$29.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.89 / $32.34 / $39.94	Professional		$8.89	$32.34	$39.94
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $34.21 / $53.42	Professional		$26.69	$34.21	$53.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.23 / $12.86	Professional	26	$6.52	$8.23	$12.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $26.12 / $42.22	Professional	TC	$19.93	$26.12	$42.22