Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $151.36 / $263.03	Facility	26	$89.13	$151.36	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $776.25	Professional		$208.93	$338.84	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $117.49 / $323.59	Professional	26	$77.62	$117.49	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $77.62 / $117.49	Professional	26	$63.10	$77.62	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $302.00 / $630.96	Professional		$107.15	$302.00	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $724.44	Professional		$275.42	$457.09	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $169.82	Professional	26	$72.44	$114.82	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $630.96 / $1,905.46	Professional		$338.84	$630.96	$1,905.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $169.82 / $630.96	Professional	26	$97.72	$169.82	$630.96
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 $354.81 / $363.08 / $398.11	Professional		$354.81	$363.08	$398.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $104.71 / $112.20	Professional	26	$102.33	$104.71	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $707.95	Professional		$316.23	$457.09	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $165.96	Professional	26	$81.28	$107.15	$165.96