Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $17.78 / $45.71	Facility	26	$13.49	$17.78	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $36.31 / $81.28	Professional		$17.38	$36.31	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $20.89 / $56.23	Professional	26	$10.00	$20.89	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $23.44 / $44.67	Professional	TC	$10.47	$23.44	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.85 / $23.44	Professional	26	$11.22	$15.85	$23.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	TC	$36.31	$36.31	$36.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $47.86 / $95.50	Professional		$19.05	$47.86	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $35.48 / $74.13	Professional		$18.62	$35.48	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.13 / $27.54	Professional	26	$8.32	$14.13	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $22.39 / $46.77	Professional	TC	$10.72	$22.39	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $131.83	Professional		$43.65	$83.18	$131.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $26.92 / $102.33	Professional	26	$15.49	$26.92	$102.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $36.31 / $72.44	Professional	TC	$11.48	$36.31	$72.44
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 Professional Modifier Low / Median / High Price $51.29 / $51.29 / $56.23	Professional		$51.29	$51.29	$56.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.62 / $19.95	Professional	26	$18.20	$18.62	$19.95
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.88 / $36.31	Professional	TC	$32.36	$33.88	$36.31
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 $19.50 / $38.02 / $74.13	Professional		$19.50	$38.02	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $14.79 / $27.54	Professional	26	$8.13	$14.79	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $24.55 / $46.77	Professional	TC	$10.96	$24.55	$46.77