Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $75.86 / $128.82	Facility	26	$39.81	$75.86	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $389.05	Professional		$173.78	$218.78	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $309.03	Professional	TC	$134.90	$173.78	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $194.98 / $446.68	Professional		$53.70	$194.98	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $489.78	Professional		$194.98	$288.40	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $234.42 / $407.38	Professional	TC	$151.36	$234.42	$407.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $1,258.93	Professional		$204.17	$331.13	$1,258.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $69.18 / $295.12	Professional	26	$45.71	$69.18	$295.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $251.19 / $912.01	Professional	TC	$162.18	$251.19	$912.01
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 $239.88 / $245.47 / $263.03	Professional		$239.88	$245.47	$263.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $194.98 / $208.93	Professional	TC	$186.21	$194.98	$208.93
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 $218.78 / $302.00 / $426.58	Professional		$218.78	$302.00	$426.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $239.88 / $338.84	Professional	TC	$177.83	$239.88	$338.84