Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.62 / $41.58 / $54.33	Facility	26	$21.62	$41.58	$54.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.67 / $134.65 / $193.24	Professional		$104.67	$134.65	$193.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.42 / $111.71 / $154.18	Professional	TC	$84.42	$111.71	$154.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $104.37 / $306.14	Professional		$29.06	$104.37	$306.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.64 / $160.53 / $251.27	Professional		$101.64	$160.53	$251.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.88 / $138.55 / $211.17	Professional	TC	$83.88	$138.55	$211.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.58 / $219.23 / $405.45	Professional		$149.58	$219.23	$405.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $39.69 / $81.69	Professional	26	$28.11	$39.69	$81.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.59 / $179.98 / $332.42	Professional	TC	$121.59	$179.98	$332.42
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 $162.53 / $167.65 / $180.73	Professional		$162.53	$167.65	$180.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.85 / $139.52 / $150.54	Professional	TC	$133.85	$139.52	$150.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $32.34 / $189.07	Professional		$31.58	$32.34	$189.07
United Facility/Professional Professional Modifier Low / Median / High Price $112.53 / $147.34 / $242.25	Professional		$112.53	$147.34	$242.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.64 / $125.45 / $207.42	Professional	TC	$89.64	$125.45	$207.42