Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.25 / $94.33 / $94.33	Facility	26	$60.25	$94.33	$94.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.66 / $171.32 / $296.56	Professional		$144.66	$171.32	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.61 / $60.76 / $96.94	Professional	26	$53.61	$60.76	$96.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.06 / $112.26 / $206.54	Professional	TC	$91.06	$112.26	$206.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.61 / $210.64 / $514.30	Professional		$64.61	$210.64	$514.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.33 / $394.88 / $587.09	Professional		$275.33	$394.88	$587.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.06 / $78.65 / $112.65	Professional	26	$57.06	$78.65	$112.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.70 / $316.23 / $470.03	Professional	TC	$218.70	$316.23	$470.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $442.90 / $632.04	Professional		$311.58	$442.90	$632.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $89.14 / $160.68	Professional	26	$64.09	$89.14	$160.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $230.16 / $327.94 / $488.82	Professional	TC	$230.16	$327.94	$488.82
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 $342.36 / $352.64 / $380.25	Professional		$342.36	$352.64	$380.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.38 / $71.59 / $75.73	Professional	26	$70.38	$71.59	$75.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $270.77 / $282.26 / $304.51	Professional	TC	$270.77	$282.26	$304.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $79.23 / $228.17	Professional		$32.34	$79.23	$228.17
United Facility/Professional Professional Modifier Low / Median / High Price $289.01 / $379.57 / $644.58	Professional		$289.01	$379.57	$644.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.56 / $75.69 / $127.36	Professional	26	$55.56	$75.69	$127.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.70 / $312.26 / $512.03	Professional	TC	$233.70	$312.26	$512.03