Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $69.18 / $120.23	Facility	26	$37.15	$69.18	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $173.78	Professional		$81.28	$107.15	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $117.49	Professional	TC	$50.12	$67.61	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $125.89 / $223.87	Professional		$50.12	$125.89	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Facility	26	$51.29	$51.29	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $269.15	Professional		$85.11	$151.36	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $97.72 / $181.97	Professional	TC	$54.95	$97.72	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $281.84 / $870.96	Professional		$125.89	$281.84	$870.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $75.86 / $426.58	Professional	26	$47.86	$75.86	$426.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $134.90 / $467.74	Professional	TC	$75.86	$134.90	$467.74
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 $128.82 / $131.83 / $141.25	Professional		$128.82	$131.83	$141.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $83.18 / $89.13	Professional	TC	$79.43	$83.18	$89.13
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 $100.00 / $147.91 / $245.47	Professional		$100.00	$147.91	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $91.20 / $177.83	Professional	TC	$57.54	$91.20	$177.83