Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.28 / $16.91 / $23.21	Facility	26	$11.28	$16.91	$23.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.69 / $39.40 / $442.24	Facility	TC	$26.69	$39.40	$442.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $41.00 / $73.72	Professional		$35.22	$41.00	$73.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $12.92 / $24.77	Professional	26	$11.21	$12.92	$24.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $27.96 / $47.08	Professional	TC	$23.17	$27.96	$47.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $40.51 / $43.20	Professional		$31.83	$40.51	$43.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $12.50 / $17.23	Professional	26	$9.50	$12.50	$17.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $42.72 / $95.09	Professional		$15.96	$42.72	$95.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $54.16 / $80.15	Professional		$33.89	$54.16	$80.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $17.22 / $27.04	Professional	26	$10.80	$17.22	$27.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $36.72 / $56.29	Professional	TC	$23.42	$36.72	$56.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.51 / $73.97 / $236.16	Professional		$49.51	$73.97	$236.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $21.83 / $95.02	Professional	26	$15.16	$21.83	$95.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $45.15 / $127.23	Professional	TC	$33.11	$45.15	$127.23
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 $50.48 / $51.47 / $55.72	Professional		$50.48	$51.47	$55.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $15.77 / $16.59	Professional	26	$15.52	$15.77	$16.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $34.71 / $39.13	Professional	TC	$33.26	$34.71	$39.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $32.34 / $58.29	Professional		$17.35	$32.34	$58.29
United Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $51.53 / $79.16	Professional		$38.50	$51.53	$79.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.56 / $17.18 / $26.40	Professional	26	$13.56	$17.18	$26.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.44 / $33.95 / $52.67	Professional	TC	$25.44	$33.95	$52.67