Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.65 / $95.34 / $113.29	Facility	26	$59.65	$95.34	$113.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.48 / $316.45 / $559.85	Professional		$264.48	$316.45	$559.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.09 / $61.61 / $120.77	Professional	26	$56.09	$61.61	$120.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.39 / $251.71 / $470.29	Professional	TC	$208.39	$251.71	$470.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $285.32 / $675.75	Professional		$78.98	$285.32	$675.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.77 / $427.88 / $711.21	Professional		$276.77	$427.88	$711.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.88 / $88.36 / $143.75	Professional	26	$56.88	$88.36	$143.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.89 / $339.52 / $565.88	Professional	TC	$229.89	$339.52	$565.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $303.55 / $441.52 / $1,201.28	Professional		$303.55	$441.52	$1,201.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.31 / $96.46 / $323.77	Professional	26	$66.31	$96.46	$323.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $237.23 / $339.13 / $724.41	Professional	TC	$237.23	$339.13	$724.41
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 $358.74 / $369.81 / $397.32	Professional		$358.74	$369.81	$397.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.51 / $78.38 / $82.04	Professional	26	$77.51	$78.38	$82.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.98 / $280.36 / $315.27	Professional	TC	$267.98	$280.36	$315.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $85.83 / $415.66	Professional		$32.34	$85.83	$415.66
United Facility/Professional Professional Modifier Low / Median / High Price $344.57 / $452.92 / $792.32	Professional		$344.57	$452.92	$792.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.16 / $93.67 / $168.12	Professional	26	$68.16	$93.67	$168.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.16 / $358.99 / $547.40	Professional	TC	$261.16	$358.99	$547.40