Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $4.37 / $8.91	Facility	26	$3.02	$4.37	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $19.95 / $46.77	Professional		$12.88	$19.95	$46.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.98 / $8.91	Professional	26	$2.00	$3.98	$8.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $15.14 / $30.90	Professional	TC	$10.96	$15.14	$30.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $12.59 / $14.79	Professional		$11.75	$12.59	$14.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.63 / $2.63 / $2.63	Professional	26	$2.63	$2.63	$2.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $12.88 / $26.30	Professional		$3.24	$12.88	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $25.70 / $45.71	Professional		$15.85	$25.70	$45.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $5.37 / $10.23	Professional	26	$2.95	$5.37	$10.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $19.95 / $36.31	Professional	TC	$12.59	$19.95	$36.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $28.18 / $67.61	Professional		$15.14	$28.18	$67.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $6.31 / $18.62	Professional	26	$2.82	$6.31	$18.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $19.95 / $43.65	Professional	TC	$11.75	$19.95	$43.65
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 $17.78 / $17.78 / $19.95	Professional		$17.78	$17.78	$19.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $3.47 / $3.80	Professional	26	$3.02	$3.47	$3.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $14.79 / $16.22	Professional	TC	$14.45	$14.79	$16.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $32.36 / $33.11	Professional		$19.50	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $27.54 / $42.66	Professional		$19.05	$27.54	$42.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $6.17 / $9.33	Professional	26	$3.89	$6.17	$9.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $32.36	Professional	TC	$15.14	$20.89	$32.36