Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.75 / $97.51 / $97.51	Facility	26	$60.75	$97.51	$97.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.53 / $415.39 / $704.86	Professional		$362.53	$415.39	$704.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.38 / $62.46 / $88.53	Professional	26	$55.38	$62.46	$88.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $179.45 / $203.80 / $291.50	Professional	52	$179.45	$203.80	$291.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.74 / $351.36 / $596.55	Professional	TC	$304.74	$351.36	$596.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.18 / $267.50 / $636.44	Professional		$64.18	$267.50	$636.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $413.43 / $595.94 / $938.37	Professional		$413.43	$595.94	$938.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $87.77 / $136.97	Professional	26	$61.36	$87.77	$136.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $352.06 / $500.64 / $804.97	Professional	TC	$352.06	$500.64	$804.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $394.95 / $595.94 / $2,796.59	Professional		$394.95	$595.94	$2,796.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $91.42 / $546.23	Professional	26	$60.24	$91.42	$546.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $348.90 / $507.49 / $2,250.36	Professional	TC	$348.90	$507.49	$2,250.36
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 $484.20 / $497.91 / $540.11	Professional		$484.20	$497.91	$540.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.88 / $71.88 / $75.23	Professional	26	$70.88	$71.88	$75.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $412.33 / $427.04 / $464.88	Professional	TC	$412.33	$427.04	$464.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $77.41 / $536.40	Professional		$32.34	$77.41	$536.40
United Facility/Professional Professional Modifier Low / Median / High Price $401.88 / $607.26 / $923.67	Professional		$401.88	$607.26	$923.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.75 / $92.09 / $137.16	Professional	26	$57.75	$92.09	$137.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $335.81 / $506.03 / $771.08	Professional	TC	$335.81	$506.03	$771.08