Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $41.69 / $69.18	Facility	26	$20.89	$41.69	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $218.78	Professional		$97.72	$131.83	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $181.97	Professional	TC	$77.62	$112.20	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $104.71 / $309.03	Professional		$28.84	$104.71	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $251.19	Professional		$102.33	$154.88	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $131.83 / $208.93	Professional	TC	$83.18	$131.83	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $251.19 / $407.38	Professional		$144.54	$251.19	$407.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $43.65 / $91.20	Professional	26	$27.54	$43.65	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $186.21 / $331.13	Professional	TC	$114.82	$186.21	$331.13
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 $162.18 / $165.96 / $181.97	Professional		$162.18	$165.96	$181.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $138.04 / $151.36	Professional	TC	$134.90	$138.04	$151.36
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 $107.15 / $144.54 / $223.87	Professional		$107.15	$144.54	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $117.49 / $186.21	Professional	TC	$85.11	$117.49	$186.21