Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $95.50 / $165.96	Facility	26	$52.48	$95.50	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $323.59	Professional		$102.33	$134.90	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $288.40	Professional		$69.18	$147.91	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $602.56	Professional		$112.20	$194.98	$602.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $588.84 / $1,071.52	Professional		$147.91	$588.84	$1,071.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $512.86	Professional	26	$64.57	$112.20	$512.86
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 $151.36 / $151.36 / $165.96	Professional		$151.36	$151.36	$165.96
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 $134.90 / $208.93 / $562.34	Professional		$134.90	$208.93	$562.34