Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.53 / $23.53 / $23.53	Facility	26	$23.53	$23.53	$23.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $117.71 / $170.06	Professional		$94.49	$117.71	$170.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $14.69 / $20.30	Professional	26	$12.60	$14.69	$20.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $102.75 / $148.33	Professional	TC	$84.23	$102.75	$148.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.23 / $53.39 / $178.54	Professional		$16.23	$53.39	$178.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.10 / $140.72 / $217.72	Professional		$93.10	$140.72	$217.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $18.29 / $28.68	Professional	26	$12.87	$18.29	$28.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.85 / $131.32 / $193.51	Professional	TC	$84.85	$131.32	$193.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.48 / $159.88 / $305.95	Professional		$94.48	$159.88	$305.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $19.11 / $43.79	Professional	26	$11.78	$19.11	$43.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.31 / $140.59 / $214.00	Professional	TC	$83.31	$140.59	$214.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.03 / $145.80 / $184.59	Professional		$20.03	$145.80	$184.59
United Facility/Professional Professional Modifier Low / Median / High Price $85.22 / $107.10 / $196.39	Professional		$85.22	$107.10	$196.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $15.31 / $27.32	Professional	26	$12.42	$15.31	$27.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.18 / $90.07 / $166.21	Professional	TC	$72.18	$90.07	$166.21