Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.76 / $75.75 / $75.75	Facility	26	$46.76	$75.75	$75.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $98.85 / $132.09	Professional		$79.26	$98.85	$132.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.58 / $52.81 / $68.40	Professional	TC	$40.58	$52.81	$68.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.05 / $91.06 / $145.46	Professional		$50.05	$91.06	$145.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $52.06 / $52.06	Facility	26	$52.06	$52.06	$52.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $123.74 / $204.68	Professional		$77.86	$123.74	$204.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.20 / $60.74 / $104.09	Professional	TC	$31.20	$60.74	$104.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.22 / $127.73 / $480.83	Professional		$86.22	$127.73	$480.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.42 / $68.03 / $306.52	Professional	26	$46.42	$68.03	$306.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.72 / $60.04 / $204.12	Professional	TC	$36.72	$60.04	$204.12
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 $106.74 / $107.20 / $116.29	Professional		$106.74	$107.20	$116.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.01 / $52.60 / $57.62	Professional	TC	$51.01	$52.60	$57.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.87 / $121.65	Professional		$32.34	$42.87	$121.65
United Facility/Professional Professional Modifier Low / Median / High Price $87.78 / $122.77 / $202.00	Professional		$87.78	$122.77	$202.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.79 / $62.43 / $104.23	Professional	TC	$42.79	$62.43	$104.23