Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.23 / $23.61 / $25.16	Facility	26	$16.23	$23.61	$25.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $52.77 / $76.50	Professional		$45.13	$52.77	$76.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $16.23 / $21.70	Professional	26	$13.86	$16.23	$21.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.07 / $36.54 / $54.80	Professional	TC	$30.07	$36.54	$54.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.23 / $39.13 / $83.39	Professional		$15.23	$39.13	$83.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $64.76 / $113.67	Professional		$43.62	$64.76	$113.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $20.59 / $33.56	Professional	26	$14.44	$20.59	$33.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.39 / $43.35 / $81.98	Professional	TC	$29.39	$43.35	$81.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $60.43 / $167.93	Professional		$41.52	$60.43	$167.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $20.35 / $59.65	Professional	26	$13.79	$20.35	$59.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.18 / $38.90 / $106.88	Professional	TC	$26.18	$38.90	$106.88
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 $49.10 / $49.93 / $53.98	Professional		$49.10	$49.93	$53.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $17.07 / $17.85	Professional	26	$16.80	$17.07	$17.85
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.03 / $33.14 / $36.13	Professional	TC	$32.03	$33.14	$36.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.67 / $32.34 / $56.47	Professional		$18.67	$32.34	$56.47
United Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $66.05 / $107.23	Professional		$47.42	$66.05	$107.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $19.52 / $33.43	Professional	26	$13.79	$19.52	$33.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.53 / $47.71 / $73.73	Professional	TC	$33.53	$47.71	$73.73