Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.91 / $98.90 / $108.02	Facility	26	$58.91	$98.90	$108.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $125.65 / $201.79	Professional		$109.14	$125.65	$201.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $130.99 / $251.10	Professional		$69.95	$130.99	$251.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.41 / $167.73 / $252.79	Professional		$117.41	$167.73	$252.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $174.78 / $646.07	Professional		$123.00	$174.78	$646.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.50 / $84.53 / $324.00	Professional	26	$61.50	$84.53	$324.00
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 $133.30 / $133.65 / $145.37	Professional		$133.30	$133.65	$145.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.95 / $164.38	Professional		$32.34	$73.95	$164.38
United Facility/Professional Professional Modifier Low / Median / High Price $121.21 / $162.65 / $269.14	Professional		$121.21	$162.65	$269.14