Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.79 / $71.09 / $84.28	Facility	26	$44.79	$71.09	$84.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.32 / $305.82 / $818.35	Professional		$267.32	$305.82	$818.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.41 / $48.53 / $128.13	Professional	26	$42.41	$48.53	$128.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.84 / $261.02 / $495.22	Professional	TC	$223.84	$261.02	$495.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.34 / $213.46 / $682.28	Professional		$59.34	$213.46	$682.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.77 / $418.65 / $712.17	Professional		$260.77	$418.65	$712.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.56 / $66.38 / $108.03	Professional	26	$42.56	$66.38	$108.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.19 / $367.45 / $608.94	Professional	TC	$212.19	$367.45	$608.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $299.95 / $444.36 / $1,016.47	Professional		$299.95	$444.36	$1,016.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.79 / $72.55 / $237.88	Professional	26	$49.79	$72.55	$237.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $256.86 / $373.62 / $778.59	Professional	TC	$256.86	$373.62	$778.59
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 $362.21 / $373.72 / $403.14	Professional		$362.21	$373.72	$403.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $58.64 / $61.65	Professional	26	$57.54	$58.64	$61.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $303.56 / $316.20 / $341.50	Professional	TC	$303.56	$316.20	$341.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.48 / $421.75	Professional		$32.34	$64.48	$421.75
United Facility/Professional Professional Modifier Low / Median / High Price $293.56 / $400.88 / $695.61	Professional		$293.56	$400.88	$695.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.59 / $61.95 / $103.60	Professional	26	$49.59	$61.95	$103.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.42 / $372.22 / $572.26	Professional	TC	$249.42	$372.22	$572.26