Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $89.13 / $213.80	Facility	26	$63.10	$89.13	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $275.42	Professional		$107.15	$138.04	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $125.89	Professional		$97.72	$102.33	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $162.18 / $302.00	Professional		$89.13	$162.18	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $173.78 / $269.15	Professional		$109.65	$173.78	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $269.15 / $707.95	Professional		$147.91	$269.15	$707.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $134.90 / $338.84	Professional	26	$77.62	$134.90	$338.84
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 $158.49 / $162.18 / $177.83	Professional		$158.49	$162.18	$177.83
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 $120.23 / $158.49 / $234.42	Professional		$120.23	$158.49	$234.42