Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $51.97 / $89.46	Facility	26	$27.92	$51.97	$89.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $77.37 / $132.21	Professional		$57.58	$77.37	$132.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.02 / $28.63 / $51.97	Professional	26	$26.02	$28.63	$51.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.47 / $31.75 / $59.78	Professional	52	$28.47	$31.75	$59.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $43.74 / $71.43	Professional	TC	$30.92	$43.74	$71.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.32 / $79.23 / $151.88	Professional		$37.32	$79.23	$151.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.16 / $98.45 / $145.18	Professional		$60.16	$98.45	$145.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $40.26 / $58.74	Professional	26	$25.80	$40.26	$58.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.56 / $85.56 / $85.56	Professional	50	$85.56	$85.56	$85.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $57.07 / $90.74	Professional	TC	$33.36	$57.07	$90.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $74.66 / $111.64 / $256.32	Professional		$74.66	$111.64	$256.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.95 / $47.71 / $157.22	Professional	26	$32.95	$47.71	$157.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.84 / $59.59 / $151.21	Professional	TC	$41.84	$59.59	$151.21
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 $80.63 / $82.55 / $88.23	Professional		$80.63	$82.55	$88.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $36.93 / $38.77	Professional	26	$36.71	$36.93	$38.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.91 / $45.62 / $49.45	Professional	TC	$43.91	$45.62	$49.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $39.54 / $92.30	Professional		$32.34	$39.54	$92.30
United Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $86.87 / $127.98	Professional		$67.00	$86.87	$127.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.00 / $57.59	Professional	26	$28.18	$37.00	$57.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.92 / $49.30 / $73.64	Professional	TC	$35.92	$49.30	$73.64