Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.77 / $59.74 / $95.34	Facility	26	$29.77	$59.74	$95.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $79.14 / $153.08	Professional		$63.43	$79.14	$153.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.62 / $31.64 / $64.29	Professional	26	$27.62	$31.64	$64.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.59 / $49.35 / $80.95	Professional	TC	$35.59	$49.35	$80.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.77 / $86.60 / $166.02	Professional		$39.77	$86.60	$166.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $111.19 / $168.93	Professional		$68.28	$111.19	$168.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $44.49 / $64.51	Professional	26	$28.47	$44.49	$64.51
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.81 / $126.81 / $126.81	Professional	50	$126.81	$126.81	$126.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.50 / $63.52 / $111.00	Professional	TC	$39.50	$63.52	$111.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $122.04 / $298.54	Professional		$81.53	$122.04	$298.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $51.06 / $131.03	Professional	26	$35.11	$51.06	$131.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.59 / $66.98 / $188.09	Professional	TC	$46.59	$66.98	$188.09
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 $88.14 / $90.30 / $96.36	Professional		$88.14	$90.30	$96.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $39.46 / $41.31	Professional	26	$39.22	$39.46	$41.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.91 / $50.84 / $55.06	Professional	TC	$48.91	$50.84	$55.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.25 / $100.80	Professional		$32.34	$42.25	$100.80
United Facility/Professional Professional Modifier Low / Median / High Price $84.22 / $114.16 / $183.60	Professional		$84.22	$114.16	$183.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $40.26 / $64.48	Professional	26	$31.60	$40.26	$64.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.68 / $73.52 / $119.68	Professional	TC	$51.68	$73.52	$119.68