Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.44 / $93.69 / $226.37	Facility	26	$91.44	$93.69	$226.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.66 / $209.52 / $332.03	Professional		$148.66	$209.52	$332.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $85.30 / $154.78	Professional	26	$49.34	$85.30	$154.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $122.88 / $122.88 / $127.20	Professional	26	$122.88	$122.88	$127.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.07 / $217.95 / $390.84	Professional		$121.07	$217.95	$390.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $261.23 / $632.00	Professional		$137.72	$261.23	$632.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.30 / $103.97 / $172.38	Professional	26	$59.30	$103.97	$172.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $194.15 / $319.22 / $654.66	Professional		$194.15	$319.22	$654.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.95 / $154.46 / $385.43	Professional	26	$99.95	$154.46	$385.43
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 $205.01 / $207.49 / $226.41	Professional		$205.01	$207.49	$226.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.18 / $118.12 / $125.76	Professional	26	$112.18	$118.12	$125.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.24 / $236.86	Professional		$32.34	$96.24	$236.86
United Facility/Professional Professional Modifier Low / Median / High Price $178.29 / $255.84 / $529.32	Professional		$178.29	$255.84	$529.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $100.33 / $186.89	Professional	26	$58.62	$100.33	$186.89