Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $96.70 / $96.70	Facility	26	$59.91	$96.70	$96.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.17 / $159.09 / $264.20	Professional		$110.17	$159.09	$264.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $66.15 / $113.09	Professional	26	$54.53	$66.15	$113.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.75 / $84.63 / $182.08	Professional	TC	$52.75	$84.63	$182.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $119.29 / $210.07	Professional		$65.30	$119.29	$210.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.40 / $178.67 / $302.76	Professional		$119.40	$178.67	$302.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.20 / $79.48 / $125.64	Professional	26	$58.20	$79.48	$125.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.14 / $88.59 / $184.98	Professional	TC	$57.14	$88.59	$184.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.46 / $186.85 / $710.63	Professional		$128.46	$186.85	$710.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.77 / $91.26 / $472.48	Professional	26	$64.77	$91.26	$472.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.69 / $91.68 / $375.06	Professional	TC	$63.69	$91.68	$375.06
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 $139.84 / $141.79 / $151.81	Professional		$139.84	$141.79	$151.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.03 / $72.90 / $76.54	Professional	26	$72.03	$72.90	$76.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.92 / $69.76 / $75.27	Professional	TC	$66.92	$69.76	$75.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.06 / $158.82	Professional		$32.34	$72.06	$158.82
United Facility/Professional Professional Modifier Low / Median / High Price $123.74 / $186.53 / $316.24	Professional		$123.74	$186.53	$316.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $80.14 / $128.25	Professional	26	$58.88	$80.14	$128.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.21 / $98.25 / $157.41	Professional	TC	$61.21	$98.25	$157.41