Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.78 / $67.13 / $67.13	Facility	26	$35.78	$67.13	$67.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.11 / $142.36 / $275.00	Professional		$103.11	$142.36	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.33 / $47.85 / $93.79	Professional	26	$34.33	$47.85	$93.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $202.03 / $202.03 / $604.69	Professional	50	$202.03	$202.03	$604.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $92.23 / $200.77	Professional	TC	$66.81	$92.23	$200.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.80 / $137.22 / $233.50	Professional		$45.80	$137.22	$233.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.99 / $172.09 / $278.47	Professional		$114.99	$172.09	$278.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.08 / $56.99 / $89.87	Professional	26	$38.08	$56.99	$89.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.03 / $115.05 / $188.76	Professional	TC	$72.03	$115.05	$188.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $164.26 / $234.66 / $391.10	Professional		$164.26	$234.66	$391.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.79 / $65.93 / $196.01	Professional	26	$48.79	$65.93	$196.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.48 / $154.30 / $256.30	Professional	TC	$96.48	$154.30	$256.30
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 $184.18 / $190.78 / $203.37	Professional		$184.18	$190.78	$203.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.91 / $51.40 / $53.69	Professional	26	$50.91	$51.40	$53.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.28 / $139.37 / $149.69	Professional	TC	$133.28	$139.37	$149.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $56.17 / $212.76	Professional		$32.34	$56.17	$212.76
United Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $148.22 / $219.64	Professional		$103.09	$148.22	$219.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.13 / $54.29 / $93.61	Professional	26	$41.13	$54.29	$93.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.14 / $90.08 / $144.41	Professional	TC	$58.14	$90.08	$144.41