Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.45 / $122.65 / $275.76	Facility	26	$82.45	$122.65	$275.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.68 / $148.43 / $271.06	Professional		$126.68	$148.43	$271.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.23 / $54.22 / $105.14	Professional	TC	$44.23	$54.22	$105.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.03 / $214.55 / $331.60	Professional		$115.03	$214.55	$331.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $214.38 / $305.12	Professional		$127.76	$214.38	$305.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.42 / $79.08 / $134.53	Professional	TC	$47.42	$79.08	$134.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $236.97 / $707.83	Professional		$148.94	$236.97	$707.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.81 / $156.26 / $692.70	Professional	26	$96.81	$156.26	$692.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.92 / $85.52 / $585.65	Professional	TC	$53.92	$85.52	$585.65
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 $176.03 / $176.89 / $189.58	Professional		$176.03	$176.89	$189.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.14 / $64.26 / $70.09	Professional	TC	$62.14	$64.26	$70.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $79.26 / $198.33	Professional		$32.34	$79.26	$198.33
United Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $198.16 / $358.75	Professional		$152.66	$198.16	$358.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $70.98 / $121.89	Professional	TC	$51.97	$70.98	$121.89