Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.91 / $143.02 / $745.68	Facility		$63.91	$143.02	$745.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $70.53 / $73.73	Facility	26	$36.93	$70.53	$73.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.92 / $81.75 / $276.79	Professional		$55.92	$81.75	$276.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $54.62 / $112.80	Professional	26	$34.40	$54.62	$112.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.88 / $39.34 / $169.55	Professional	TC	$25.88	$39.34	$169.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.56 / $325.06 / $756.19	Facility		$187.56	$325.06	$756.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $75.43 / $123.45	Professional		$43.38	$75.43	$123.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.60 / $71.95 / $71.95	Facility		$51.60	$71.95	$71.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.77 / $116.41 / $327.52	Professional		$70.77	$116.41	$327.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.49 / $66.95 / $152.51	Professional	26	$39.49	$66.95	$152.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.18 / $49.46 / $213.32	Professional	TC	$29.18	$49.46	$213.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.43 / $111.18 / $701.88	Professional		$65.43	$111.18	$701.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $63.94 / $494.41	Professional	26	$37.74	$63.94	$494.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $45.85 / $389.04	Professional	TC	$27.10	$45.85	$389.04
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
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 $76.78 / $77.79 / $85.02	Professional		$76.78	$77.79	$85.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $45.76 / $48.89	Professional	26	$43.64	$45.76	$48.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.03 / $33.14 / $36.13	Professional	TC	$32.03	$33.14	$36.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $34.74 / $96.14	Professional		$32.34	$34.74	$96.14
United Facility/Professional Facility Modifier Low / Median / High Price $130.47 / $741.00 / $3,399.00	Facility		$130.47	$741.00	$3,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $145.41 / $340.43	Professional		$65.76	$145.41	$340.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.68 / $78.88 / $120.87	Professional	26	$37.68	$78.88	$120.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.08 / $58.78 / $181.61	Professional	TC	$28.08	$58.78	$181.61