Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $104.71 / $288.40	Facility	26	$85.11	$104.71	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $416.87	Professional		$131.83	$199.53	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $95.50 / $380.19	Professional	26	$56.23	$95.50	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $89.13	Professional	26	$69.18	$87.10	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $218.78 / $331.13	Professional		$120.23	$218.78	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $251.19 / $602.56	Professional		$138.04	$251.19	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $95.50 / $169.82	Professional	26	$56.23	$95.50	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $407.38 / $676.08	Professional		$199.53	$407.38	$676.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $169.82 / $467.74	Professional	26	$100.00	$169.82	$467.74
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 $204.17 / $208.93 / $223.87	Professional		$204.17	$208.93	$223.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $117.49 / $125.89	Professional	26	$112.20	$117.49	$125.89
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 $169.82 / $251.19 / $575.44	Professional		$169.82	$251.19	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $95.50 / $169.82	Professional	26	$57.54	$95.50	$169.82