Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.93 / $51.93 / $51.93	Facility		$51.93	$51.93	$51.93
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.62 / $25.62 / $25.62	Facility	26	$25.62	$25.62	$25.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $31.08 / $52.54	Professional		$25.39	$31.08	$52.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.44 / $15.00 / $22.32	Professional	26	$12.44	$15.00	$22.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.96 / $16.22 / $35.28	Professional	TC	$12.96	$16.22	$35.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.41 / $149.41 / $149.41	Facility		$149.41	$149.41	$149.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $34.00 / $43.65	Professional		$17.43	$34.00	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.88 / $96.88 / $96.88	Facility		$96.88	$96.88	$96.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $49.05 / $97.19	Professional		$28.23	$49.05	$97.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $20.70 / $31.59	Professional	26	$13.55	$20.70	$31.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.64 / $26.79 / $76.18	Professional	TC	$14.64	$26.79	$76.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $43.78 / $101.65	Professional		$26.86	$43.78	$101.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $20.44 / $56.00	Professional	26	$12.58	$20.44	$56.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.82 / $21.57 / $44.65	Professional	TC	$12.82	$21.57	$44.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.25 / $47.01	Professional		$21.38	$26.25	$47.01
United Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $37.72 / $65.31	Professional		$28.74	$37.72	$65.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $16.41 / $28.07	Professional	26	$13.28	$16.41	$28.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.95 / $20.56 / $36.24	Professional	TC	$14.95	$20.56	$36.24