Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.81 / $72.39 / $117.60	Facility	26	$45.81	$72.39	$117.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.74 / $344.07 / $492.50	Professional		$287.74	$344.07	$492.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $139.86 / $172.04 / $241.64	Professional	52	$139.86	$172.04	$241.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.80 / $301.02 / $428.38	Professional	TC	$247.80	$301.02	$428.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.74 / $161.77 / $590.20	Professional		$49.74	$161.77	$590.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $50.88 / $50.88	Facility	26	$50.88	$50.88	$50.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.87 / $501.86 / $733.30	Professional		$348.87	$501.86	$733.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $298.44 / $441.31 / $638.15	Professional	TC	$298.44	$441.31	$638.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $349.84 / $533.09 / $5,450.83	Professional		$349.84	$533.09	$5,450.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.85 / $66.81 / $977.05	Professional	26	$44.85	$66.81	$977.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.98 / $445.06 / $3,813.64	Professional	TC	$318.98	$445.06	$3,813.64
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 $433.13 / $448.96 / $483.28	Professional		$433.13	$448.96	$483.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $361.22 / $378.16 / $424.97	Professional	TC	$361.22	$378.16	$424.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $59.21 / $490.35	Professional		$32.34	$59.21	$490.35
United Facility/Professional Professional Modifier Low / Median / High Price $316.16 / $445.81 / $712.67	Professional		$316.16	$445.81	$712.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.42 / $392.20 / $628.45	Professional	TC	$264.42	$392.20	$628.45