Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $48.98 / $85.11	Facility	26	$25.70	$48.98	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $229.09	Professional		$85.11	$123.03	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $95.50	Professional	26	$21.88	$30.90	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $165.96	Professional	TC	$66.07	$97.72	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $107.15 / $275.42	Professional		$35.48	$107.15	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $234.42	Professional		$93.33	$147.91	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $38.02 / $57.54	Professional	26	$23.44	$38.02	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $112.20 / $181.97	Professional	TC	$72.44	$112.20	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $251.19 / $537.03	Professional		$138.04	$251.19	$537.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $56.23 / $154.88	Professional	26	$33.11	$56.23	$154.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $173.78 / $416.87	Professional	TC	$102.33	$173.78	$416.87
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 $147.91 / $151.36 / $162.18	Professional		$147.91	$151.36	$162.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $37.15	Professional	26	$33.11	$34.67	$37.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $117.49 / $125.89	Professional	TC	$112.20	$117.49	$125.89
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 / $138.04 / $213.80	Professional		$100.00	$138.04	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $53.70	Professional	26	$26.92	$33.88	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $102.33 / $162.18	Professional	TC	$74.13	$102.33	$162.18