Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $151.36 / $426.58	Facility	26	$89.13	$151.36	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $512.86 / $1,584.89	Professional		$346.74	$512.86	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $371.54	Professional	26	$85.11	$141.25	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $776.25	Professional	TC	$257.04	$371.54	$776.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $338.84 / $758.58	Professional		$107.15	$338.84	$758.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $933.25	Professional		$338.84	$524.81	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $177.83	Professional	26	$72.44	$120.23	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $398.11 / $758.58	Professional	TC	$251.19	$398.11	$758.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $724.44 / $2,818.38	Professional		$371.54	$724.44	$2,818.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $165.96 / $724.44	Professional	26	$102.33	$165.96	$724.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $575.44 / $2,238.72	Professional	TC	$288.40	$575.44	$2,238.72
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 $398.11 / $407.38 / $446.68	Professional		$398.11	$407.38	$446.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $104.71 / $112.20	Professional	26	$102.33	$104.71	$112.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $309.03 / $331.13	Professional	TC	$295.12	$309.03	$331.13
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 $371.54 / $537.03 / $794.33	Professional		$371.54	$537.03	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $104.71 / $162.18	Professional	26	$81.28	$104.71	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $426.58 / $660.69	Professional	TC	$281.84	$426.58	$660.69