Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.02 / $252.67 / $465.69	Facility	26	$142.02	$252.67	$465.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $412.71 / $732.91	Professional		$317.47	$412.71	$732.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $142.02 / $249.77	Professional	26	$131.81	$142.02	$249.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $259.94 / $431.80	Professional	TC	$185.65	$259.94	$431.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.26 / $539.16 / $1,033.58	Professional		$194.26	$539.16	$1,033.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.73 / $567.57 / $838.58	Professional		$372.73	$567.57	$838.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $148.04 / $209.56 / $326.89	Professional	26	$148.04	$209.56	$326.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.91 / $366.97 / $552.95	Professional	TC	$227.91	$366.97	$552.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $464.29 / $707.13 / $2,064.36	Professional		$464.29	$707.13	$2,064.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $160.84 / $232.85 / $701.17	Professional	26	$160.84	$232.85	$701.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $310.64 / $441.38 / $976.68	Professional	TC	$310.64	$441.38	$976.68
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 $548.70 / $559.88 / $605.64	Professional		$548.70	$559.88	$605.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $171.53 / $187.34 / $201.80	Professional	26	$171.53	$187.34	$201.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $343.27 / $358.62 / $403.85	Professional	TC	$343.27	$358.62	$403.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $228.19 / $633.60	Professional		$32.34	$228.19	$633.60
United Facility/Professional Professional Modifier Low / Median / High Price $364.67 / $501.54 / $781.93	Professional		$364.67	$501.54	$781.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $152.43 / $199.64 / $313.05	Professional	26	$152.43	$199.64	$313.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.80 / $301.08 / $480.85	Professional	TC	$210.80	$301.08	$480.85