Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.04 / $95.14 / $130.03	Facility	26	$52.04	$95.14	$130.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.34 / $132.88 / $240.26	Professional		$108.34	$132.88	$240.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.55 / $149.29 / $286.19	Professional		$69.55	$149.29	$286.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.85 / $196.89 / $633.12	Professional		$112.85	$196.89	$633.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.09 / $233.74 / $942.36	Professional		$146.09	$233.74	$942.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.95 / $94.47 / $456.54	Professional	26	$64.95	$94.47	$456.54
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 $151.41 / $151.93 / $167.30	Professional		$151.41	$151.93	$167.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.73 / $175.02	Professional		$32.34	$72.73	$175.02
United Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $213.95 / $487.28	Professional		$137.19	$213.95	$487.28