Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.28 / $42.92 / $42.92	Facility	26	$27.28	$42.92	$42.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.28 / $161.19 / $201.86	Professional		$114.28	$161.19	$201.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.39 / $135.79 / $169.43	Professional	TC	$90.39	$135.79	$169.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $97.32 / $280.77	Professional		$29.76	$97.32	$280.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.63 / $220.88 / $324.61	Professional		$107.63	$220.88	$324.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.94 / $185.06 / $267.70	Professional	TC	$71.94	$185.06	$267.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.19 / $243.13 / $685.89	Professional		$148.19	$243.13	$685.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $40.31 / $179.77	Professional	26	$27.75	$40.31	$179.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $119.75 / $203.58 / $503.65	Professional	TC	$119.75	$203.58	$503.65
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 $206.05 / $212.28 / $229.71	Professional		$206.05	$212.28	$229.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $172.98 / $179.63 / $194.82	Professional	TC	$172.98	$179.63	$194.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $35.61 / $240.31	Professional		$32.34	$35.61	$240.31
United Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $184.68 / $275.88	Professional		$113.26	$184.68	$275.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.04 / $138.97 / $219.55	Professional	TC	$86.04	$138.97	$219.55