Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.30 / $90.46 / $90.46	Facility	26	$57.30	$90.46	$90.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $384.49 / $561.17	Professional		$316.31	$384.49	$561.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $330.02 / $480.65	Professional	TC	$264.98	$330.02	$480.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $201.40 / $637.22	Professional		$61.73	$201.40	$637.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.02 / $541.33 / $777.88	Professional		$256.02	$541.33	$777.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.47 / $468.41 / $673.80	Professional	TC	$199.47	$468.41	$673.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $344.44 / $575.53 / $1,387.69	Professional		$344.44	$575.53	$1,387.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.92 / $83.06 / $306.88	Professional	26	$57.92	$83.06	$306.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.61 / $497.05 / $1,080.81	Professional	TC	$288.61	$497.05	$1,080.81
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 $459.66 / $485.33 / $540.77	Professional		$459.66	$485.33	$540.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $398.15 / $416.88 / $468.42	Professional	TC	$398.15	$416.88	$468.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.65 / $540.48	Professional		$32.34	$52.65	$540.48
United Facility/Professional Professional Modifier Low / Median / High Price $275.95 / $451.00 / $794.27	Professional		$275.95	$451.00	$794.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $391.15 / $666.44	Professional	TC	$218.71	$391.15	$666.44