Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.93 / $68.06 / $81.33	Facility	26	$42.93	$68.06	$81.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.70 / $228.16 / $372.39	Professional		$178.70	$228.16	$372.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.18 / $46.28 / $84.48	Professional	26	$40.18	$46.28	$84.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.52 / $185.40 / $295.56	Professional	TC	$138.52	$185.40	$295.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.88 / $204.54 / $456.97	Professional		$56.88	$204.54	$456.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.62 / $298.57 / $479.57	Professional		$197.62	$298.57	$479.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $63.63 / $103.47	Professional	26	$41.56	$63.63	$103.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.09 / $238.12 / $391.64	Professional	TC	$154.09	$238.12	$391.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $205.27 / $316.56 / $949.93	Professional		$205.27	$316.56	$949.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.72 / $70.02 / $234.71	Professional	26	$47.72	$70.02	$234.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $164.73 / $250.29 / $757.61	Professional	TC	$164.73	$250.29	$757.61
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 $242.59 / $248.77 / $268.97	Professional		$242.59	$248.77	$268.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.04 / $56.19 / $59.09	Professional	26	$55.04	$56.19	$59.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.41 / $193.73 / $209.89	Professional	TC	$186.41	$193.73	$209.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.81 / $281.38	Professional		$32.34	$61.81	$281.38
United Facility/Professional Professional Modifier Low / Median / High Price $233.25 / $297.19 / $439.74	Professional		$233.25	$297.19	$439.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.67 / $61.54 / $99.37	Professional	26	$48.67	$61.54	$99.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.98 / $242.08 / $340.86	Professional	TC	$183.98	$242.08	$340.86