Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.80 / $14.75 / $19.52	Facility	26	$9.80	$14.75	$19.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.42 / $34.78 / $321.95	Facility	TC	$22.42	$34.78	$321.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $36.86 / $84.40	Professional		$30.19	$36.86	$84.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $15.46 / $54.15	Professional	26	$9.91	$15.46	$54.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $24.85 / $55.35	Professional	TC	$19.89	$24.85	$55.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $27.63 / $35.11	Professional		$22.02	$27.63	$35.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.49 / $15.01	Professional	26	$8.22	$10.49	$15.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.14 / $22.48 / $31.21	Professional	TC	$22.14	$22.48	$31.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.92 / $43.05 / $82.53	Professional		$13.92	$43.05	$82.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $47.36 / $69.67	Professional		$29.24	$47.36	$69.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.02 / $23.47	Professional	26	$9.36	$15.02	$23.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $31.54 / $48.87	Professional	TC	$19.86	$31.54	$48.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $64.20 / $176.71	Professional		$42.97	$64.20	$176.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $16.86 / $54.52	Professional	26	$12.23	$16.86	$54.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.74 / $39.20 / $80.39	Professional	TC	$28.74	$39.20	$80.39
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 $43.81 / $44.56 / $48.44	Professional		$43.81	$44.56	$48.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $13.43 / $14.46	Professional	26	$12.29	$13.43	$14.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $30.11 / $33.97	Professional	TC	$28.87	$30.11	$33.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.12 / $32.34 / $50.67	Professional		$15.12	$32.34	$50.67
United Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $44.58 / $67.30	Professional		$33.29	$44.58	$67.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $14.85 / $23.03	Professional	26	$11.59	$14.85	$23.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.45 / $45.80	Professional	TC	$21.88	$29.45	$45.80