Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.65 / $160.72 / $168.08	Facility	26	$84.65	$160.72	$168.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.47 / $319.75 / $493.82	Professional		$295.47	$319.75	$493.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.65 / $88.54 / $162.08	Professional	26	$84.65	$88.54	$162.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.76 / $231.34 / $327.33	Professional	TC	$208.76	$231.34	$327.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $274.70 / $549.54	Professional		$100.33	$274.70	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.23 / $392.31 / $621.86	Professional		$294.23	$392.31	$621.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.27 / $121.57 / $174.45	Professional	26	$91.27	$121.57	$174.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.55 / $272.63 / $450.01	Professional	TC	$212.55	$272.63	$450.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $294.23 / $442.44 / $932.65	Professional		$294.23	$442.44	$932.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.69 / $139.18 / $390.69	Professional	26	$95.69	$139.18	$390.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $202.89 / $300.98 / $565.58	Professional	TC	$202.89	$300.98	$565.58
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 $328.95 / $333.16 / $364.29	Professional		$328.95	$333.16	$364.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.49 / $105.35 / $113.09	Professional	26	$99.49	$105.35	$113.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.59 / $233.69 / $251.20	Professional	TC	$223.59	$233.69	$251.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $127.88 / $411.92	Professional		$32.34	$127.88	$411.92
United Facility/Professional Professional Modifier Low / Median / High Price $295.83 / $420.06 / $613.29	Professional		$295.83	$420.06	$613.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.64 / $125.03 / $191.27	Professional	26	$88.64	$125.03	$191.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.19 / $298.10 / $522.08	Professional	TC	$207.19	$298.10	$522.08