Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.10 / $83.77 / $98.40	Facility	26	$57.10	$83.77	$98.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.58 / $206.84 / $338.64	Professional		$172.58	$206.84	$338.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $53.70 / $86.69	Professional	26	$42.60	$53.70	$86.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $50.41 / $50.42	Professional	26	$39.54	$50.41	$50.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $249.19 / $477.70	Professional		$74.90	$249.19	$477.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.25 / $273.20 / $403.25	Professional		$161.25	$273.20	$403.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.48 / $75.63 / $113.42	Professional	26	$44.48	$75.63	$113.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $226.13 / $344.58 / $634.42	Professional		$226.13	$344.58	$634.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.12 / $99.95 / $218.66	Professional	26	$67.12	$99.95	$218.66
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 $253.60 / $259.74 / $279.97	Professional		$253.60	$259.74	$279.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.93 / $73.72 / $77.81	Professional	26	$71.93	$73.72	$77.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $81.40 / $292.89	Professional		$32.34	$81.40	$292.89
United Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $263.23 / $413.23	Professional		$198.22	$263.23	$413.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.81 / $73.31 / $120.43	Professional	26	$50.81	$73.31	$120.43