Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.46 / $141.81 / $155.55	Facility	26	$83.46	$141.81	$155.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.65 / $225.72 / $325.02	Professional		$136.65	$225.72	$325.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $90.82 / $158.90	Professional	26	$77.76	$90.82	$158.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.12 / $107.12 / $107.12	Professional	26	$107.12	$107.12	$107.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.87 / $201.77 / $360.57	Professional		$121.87	$201.77	$360.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $246.68 / $694.88	Professional		$139.16	$246.68	$694.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.51 / $126.02 / $186.98	Professional	26	$76.51	$126.02	$186.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $178.16 / $294.48 / $1,050.25	Professional		$178.16	$294.48	$1,050.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.24 / $163.06 / $692.02	Professional	26	$113.24	$163.06	$692.02
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 $185.90 / $191.41 / $209.60	Professional		$185.90	$191.41	$209.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.56 / $117.77 / $126.59	Professional	26	$109.56	$117.77	$126.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $86.84 / $219.27	Professional		$32.34	$86.84	$219.27
United Facility/Professional Professional Modifier Low / Median / High Price $168.72 / $258.16 / $595.09	Professional		$168.72	$258.16	$595.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.99 / $119.46 / $189.36	Professional	26	$89.99	$119.46	$189.36