Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $190.55	Professional		$70.79	$104.71	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $109.65	Professional	26	$21.88	$30.20	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $77.62 / $138.04	Professional	TC	$50.12	$77.62	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $100.00 / $204.17	Professional		$36.31	$100.00	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $208.93	Professional		$40.74	$64.57	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $53.70	Professional	26	$13.49	$17.38	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $48.98 / $158.49	Professional	TC	$27.54	$48.98	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $457.09	Professional		$141.25	$208.93	$457.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $54.95 / $251.19	Professional	26	$36.31	$54.95	$251.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $138.04 / $257.04	Professional	TC	$93.33	$138.04	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $173.78	Professional		$69.18	$93.33	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $52.48	Professional	26	$20.89	$28.18	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $123.03	Professional	TC	$47.86	$61.66	$123.03