Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $125.89 / $354.81	Facility	26	$75.86	$125.89	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $436.52 / $1,348.96	Professional		$251.19	$436.52	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $302.00	Professional	26	$70.79	$120.23	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $288.40 / $588.84	Professional	TC	$177.83	$288.40	$588.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $251.19 / $562.34	Professional		$89.13	$251.19	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $467.74 / $831.76	Professional		$257.04	$467.74	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $93.33 / $151.36	Professional	26	$54.95	$93.33	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $331.13 / $724.44	Professional	TC	$186.21	$331.13	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $660.69 / $2,454.71	Professional		$281.84	$660.69	$2,454.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $134.90 / $812.83	Professional	26	$81.28	$134.90	$812.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $524.81 / $1,778.28	Professional	TC	$204.17	$524.81	$1,778.28
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 $295.12 / $302.00 / $323.59	Professional		$295.12	$302.00	$323.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $93.33	Professional	26	$85.11	$87.10	$93.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $213.80 / $234.42	Professional	TC	$208.93	$213.80	$234.42
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 $263.03 / $467.74 / $776.25	Professional		$263.03	$467.74	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $138.04	Professional	26	$58.88	$79.43	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $354.81 / $691.83	Professional	TC	$190.55	$354.81	$691.83