Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.89 / $58.23 / $74.03	Facility	26	$40.89	$58.23	$74.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $78.62 / $137.63	Professional		$66.73	$78.62	$137.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.94 / $46.82 / $87.62	Professional	26	$37.94	$46.82	$87.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $37.85 / $66.18	Professional	TC	$22.57	$37.85	$66.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $74.76 / $144.13	Professional		$39.54	$74.76	$144.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.47 / $95.92 / $154.55	Professional		$71.47	$95.92	$154.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $53.48 / $91.93	Professional	26	$37.25	$53.48	$91.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.46 / $43.90 / $66.19	Professional	TC	$26.46	$43.90	$66.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.05 / $104.45 / $212.13	Professional		$71.05	$104.45	$212.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $50.79 / $141.47	Professional	26	$35.54	$50.79	$141.47
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.65 / $47.13 / $81.53	Professional	TC	$32.65	$47.13	$81.53
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 $84.86 / $85.62 / $92.37	Professional		$84.86	$85.62	$92.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $43.23 / $46.35	Professional	26	$39.39	$43.23	$46.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.11 / $40.85 / $46.02	Professional	TC	$39.11	$40.85	$46.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.85 / $96.63	Professional		$32.34	$43.85	$96.63
United Facility/Professional Professional Modifier Low / Median / High Price $59.88 / $82.31 / $128.16	Professional		$59.88	$82.31	$128.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.53 / $51.11 / $79.22	Professional	26	$35.53	$51.11	$79.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.93 / $31.76 / $52.74	Professional	TC	$18.93	$31.76	$52.74