Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.86 / $174.75 / $324.83	Facility	26	$100.86	$174.75	$324.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $783.02 / $907.55 / $1,350.16	Professional		$783.02	$907.55	$1,350.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $644.71 / $806.69 / $1,176.71	Professional	TC	$644.71	$806.69	$1,176.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.50 / $408.61 / $2,064.46	Professional		$135.50	$408.61	$2,064.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.43 / $1,153.76 / $1,766.68	Professional		$377.43	$1,153.76	$1,766.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.15 / $1,041.09 / $1,573.53	Professional	TC	$235.15	$1,041.09	$1,573.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $674.44 / $1,365.75 / $2,970.29	Professional		$674.44	$1,365.75	$2,970.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.69 / $170.27 / $421.57	Professional	26	$113.69	$170.27	$421.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $672.55 / $1,206.74 / $2,504.25	Professional	TC	$672.55	$1,206.74	$2,504.25
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 $1,095.97 / $1,127.89 / $1,228.18	Professional		$1,095.97	$1,127.89	$1,228.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $968.37 / $1,013.34 / $1,087.41	Professional	TC	$968.37	$1,013.34	$1,087.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $159.16 / $1,284.85	Professional		$32.34	$159.16	$1,284.85
United Facility/Professional Professional Modifier Low / Median / High Price $616.26 / $1,022.88 / $1,741.91	Professional		$616.26	$1,022.88	$1,741.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $518.91 / $872.70 / $1,776.61	Professional	TC	$518.91	$872.70	$1,776.61