Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $354.81 / $501.19	Facility	26	$141.25	$354.81	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $870.96	Professional		$338.84	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $416.87	Professional	26	$128.82	$162.18	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $288.40 / $512.86	Professional	TC	$199.53	$288.40	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $537.03 / $1,023.29	Professional		$194.98	$537.03	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $831.76	Professional		$371.54	$524.81	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $204.17 / $295.12	Professional	26	$138.04	$204.17	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $549.54	Professional	TC	$229.09	$338.84	$549.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $776.25 / $2,238.72	Professional		$457.09	$776.25	$2,238.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $223.87 / $870.96	Professional	26	$162.18	$223.87	$870.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $436.52 / $1,230.27	Professional	TC	$302.00	$436.52	$1,230.27
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 $549.54 / $562.34 / $602.56	Professional		$549.54	$562.34	$602.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $186.21 / $199.53	Professional	26	$169.82	$186.21	$199.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $354.81 / $407.38	Professional	TC	$346.74	$354.81	$407.38
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 $371.54 / $501.19 / $741.31	Professional		$371.54	$501.19	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $194.98 / $275.42	Professional	26	$151.36	$194.98	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $288.40 / $457.09	Professional	TC	$213.80	$288.40	$457.09