Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $14.79 / $33.11	Facility	26	$9.77	$14.79	$33.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $42.66 / $323.59	Facility	TC	$23.44	$42.66	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $51.29 / $177.83	Professional		$30.20	$51.29	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.78 / $52.48	Professional	26	$10.00	$17.78	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $66.07	Professional	TC	$19.95	$29.51	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $26.92 / $34.67	Professional		$22.39	$26.92	$34.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.33 / $14.79	Professional	26	$8.13	$9.33	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.44 / $35.48	Professional	TC	$16.60	$23.44	$35.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $37.15 / $83.18	Professional		$13.80	$37.15	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $67.61	Professional		$29.51	$44.67	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $22.91	Professional	26	$9.33	$15.14	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $46.77	Professional	TC	$20.42	$30.20	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $95.50 / $229.09	Professional		$43.65	$95.50	$229.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.98 / $63.10	Professional	26	$12.30	$16.98	$63.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $107.15	Professional	TC	$27.54	$38.02	$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 $43.65 / $44.67 / $48.98	Professional		$43.65	$44.67	$48.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $13.49 / $14.45	Professional	26	$12.30	$13.49	$14.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $30.20 / $33.88	Professional	TC	$28.84	$30.20	$33.88
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 $32.36 / $41.69 / $63.10	Professional		$32.36	$41.69	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $13.80 / $20.89	Professional	26	$11.22	$13.80	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $41.69	Professional	TC	$20.89	$28.18	$41.69