Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.73 / $163.03 / $163.03	Facility	26	$102.73	$163.03	$163.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.28 / $295.72 / $430.16	Professional		$242.28	$295.72	$430.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.82 / $102.73 / $145.08	Professional	26	$89.82	$102.73	$145.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.65 / $188.33 / $304.95	Professional	TC	$148.65	$188.33	$304.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.72 / $262.32 / $445.36	Professional		$110.72	$262.32	$445.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.62 / $392.49 / $668.12	Professional		$238.62	$392.49	$668.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.18 / $140.47 / $224.26	Professional	26	$102.18	$140.47	$224.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.19 / $257.70 / $469.20	Professional	TC	$125.19	$257.70	$469.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $264.25 / $405.60 / $710.76	Professional		$264.25	$405.60	$710.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.41 / $148.77 / $412.53	Professional	26	$103.41	$148.77	$412.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.55 / $242.25 / $401.43	Professional	TC	$102.55	$242.25	$401.43
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 $343.53 / $351.20 / $377.95	Professional		$343.53	$351.20	$377.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.65 / $122.99 / $129.79	Professional	26	$121.65	$122.99	$129.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $220.53 / $229.54 / $248.17	Professional	TC	$220.53	$229.54	$248.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $94.61 / $369.95	Professional		$32.34	$94.61	$369.95
United Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $367.29 / $605.01	Professional		$235.16	$367.29	$605.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.43 / $136.50 / $227.06	Professional	26	$95.43	$136.50	$227.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.84 / $234.56 / $371.13	Professional	TC	$137.84	$234.56	$371.13