Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.15 / $53.42 / $65.05	Facility	26	$27.15	$53.42	$65.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.76 / $95.79 / $146.96	Professional		$75.76	$95.79	$146.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.27 / $67.59 / $93.55	Professional	TC	$51.27	$67.59	$93.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $102.56 / $196.61	Professional		$34.79	$102.56	$196.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.56 / $120.43 / $191.64	Professional		$78.56	$120.43	$191.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.54 / $85.22 / $136.07	Professional	TC	$52.54	$85.22	$136.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $148.56 / $286.79	Professional		$99.36	$148.56	$286.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $47.34 / $98.51	Professional	26	$33.36	$47.34	$98.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $96.15 / $191.38	Professional	TC	$66.81	$96.15	$191.38
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 $104.38 / $105.98 / $115.27	Professional		$104.38	$105.98	$115.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.19 / $72.70 / $79.13	Professional	TC	$70.19	$72.70	$79.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.81 / $120.59	Professional		$32.34	$37.81	$120.59
United Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $126.80 / $186.89	Professional		$93.27	$126.80	$186.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.39 / $91.56 / $132.26	Professional	TC	$63.39	$91.56	$132.26