Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $66.07 / $147.91	Facility	26	$46.77	$66.07	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $223.87	Professional		$89.13	$125.89	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $123.03	Professional	26	$32.36	$50.12	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $177.83	Professional		$58.88	$85.11	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.81 / $53.70	Professional	26	$36.31	$39.81	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $125.89 / $239.88	Professional		$61.66	$125.89	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $218.78	Professional		$85.11	$141.25	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $53.70 / $89.13	Professional	26	$34.67	$53.70	$89.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $218.78 / $478.63	Professional		$112.20	$218.78	$478.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $87.10 / $245.47	Professional	26	$51.29	$87.10	$245.47
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 $128.82 / $128.82 / $138.04	Professional		$128.82	$128.82	$138.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $60.26 / $64.57	Professional	26	$57.54	$60.26	$64.57
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 $95.50 / $128.82 / $194.98	Professional		$95.50	$128.82	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $42.66 / $64.57	Professional	26	$33.88	$42.66	$64.57