Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.21 / $150.72 / $211.43	Facility	26	$90.21	$150.72	$211.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.89 / $425.00 / $600.00	Professional		$290.89	$425.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.23 / $128.66 / $224.00	Professional	26	$89.23	$128.66	$224.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.73 / $164.73 / $164.73	Professional		$164.73	$164.73	$164.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $63.89 / $63.89	Professional	26	$63.89	$63.89	$63.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.01 / $306.87 / $564.71	Professional		$106.01	$306.87	$564.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.93 / $118.93 / $118.93	Facility	26	$118.93	$118.93	$118.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.92 / $432.02 / $894.23	Professional		$274.92	$432.02	$894.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $115.96 / $180.08	Professional	26	$70.81	$115.96	$180.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $312.70 / $484.65 / $2,322.71	Professional		$312.70	$484.65	$2,322.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.65 / $144.59 / $824.18	Professional	26	$101.65	$144.59	$824.18
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 $326.68 / $333.93 / $360.02	Professional		$326.68	$333.93	$360.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.12 / $104.43 / $110.12	Professional	26	$102.12	$104.43	$110.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $115.21 / $376.64	Professional		$32.34	$115.21	$376.64
United Facility/Professional Professional Modifier Low / Median / High Price $315.60 / $493.08 / $803.59	Professional		$315.60	$493.08	$803.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.94 / $113.58 / $182.62	Professional	26	$89.94	$113.58	$182.62