Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.59 / $48.80 / $74.27	Facility	26	$29.59	$48.80	$74.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $122.49 / $187.19	Professional		$104.08	$122.49	$187.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.72 / $27.89 / $46.15	Professional	26	$22.72	$27.89	$46.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $105.00 / $105.00	Professional		$105.00	$105.00	$105.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $23.97 / $23.97	Professional	26	$23.97	$23.97	$23.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $107.83 / $240.05	Professional		$39.72	$107.83	$240.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.61 / $156.44 / $257.06	Professional		$100.61	$156.44	$257.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $39.67 / $59.80	Professional	26	$24.73	$39.67	$59.80
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $187.81	Professional	50	$164.71	$164.71	$187.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $124.99 / $183.84 / $462.64	Professional		$124.99	$183.84	$462.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $52.97 / $122.54	Professional	26	$36.69	$52.97	$122.54
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 $127.44 / $129.21 / $141.47	Professional		$127.44	$129.21	$141.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $38.26 / $41.26	Professional	26	$36.11	$38.26	$41.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.17 / $148.01	Professional		$32.34	$43.17	$148.01
United Facility/Professional Professional Modifier Low / Median / High Price $120.07 / $162.04 / $268.89	Professional		$120.07	$162.04	$268.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $36.35 / $56.79	Professional	26	$28.11	$36.35	$56.79