Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.68 / $69.56 / $94.16	Facility	26	$37.68	$69.56	$94.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.95 / $104.43 / $153.31	Professional		$87.95	$104.43	$153.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.31 / $66.75 / $100.62	Professional	TC	$54.31	$66.75	$100.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.35 / $126.08 / $221.80	Professional		$50.35	$126.08	$221.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.00 / $51.00 / $51.00	Facility	26	$51.00	$51.00	$51.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $156.22 / $275.02	Professional		$87.48	$156.22	$275.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.82 / $101.10 / $187.37	Professional	TC	$54.82	$101.10	$187.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.38 / $189.68 / $712.93	Professional		$123.38	$189.68	$712.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.29 / $68.53 / $379.65	Professional	26	$48.29	$68.53	$379.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.25 / $115.50 / $404.49	Professional	TC	$76.25	$115.50	$404.49
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 $128.31 / $130.57 / $140.91	Professional		$128.31	$130.57	$140.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $82.24 / $88.61	Professional	TC	$78.81	$82.24	$88.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.73 / $147.41	Professional		$32.34	$54.73	$147.41
United Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $147.15 / $252.42	Professional		$99.43	$147.15	$252.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.66 / $93.73 / $159.41	Professional	TC	$59.66	$93.73	$159.41