Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.73 / $131.25 / $227.76	Facility	26	$71.73	$131.25	$227.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.86 / $173.91 / $312.68	Professional		$148.86	$173.91	$312.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.17 / $71.78 / $131.25	Professional	26	$66.17	$71.78	$131.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $130.82 / $130.82	Professional		$130.82	$130.82	$130.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $96.76 / $96.76 / $96.76	Professional	26	$96.76	$96.76	$96.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.01 / $204.46 / $391.94	Professional		$95.01	$204.46	$391.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $231.35 / $345.39	Professional		$146.47	$231.35	$345.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.73 / $102.50 / $151.61	Professional	26	$65.73	$102.50	$151.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $192.32 / $277.02 / $635.75	Professional		$192.32	$277.02	$635.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.89 / $121.47 / $337.26	Professional	26	$83.89	$121.47	$337.26
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 $208.07 / $211.84 / $227.29	Professional		$208.07	$211.84	$227.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.83 / $93.78 / $98.70	Professional	26	$92.83	$93.78	$98.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.00 / $237.78	Professional		$32.34	$101.00	$237.78
United Facility/Professional Professional Modifier Low / Median / High Price $167.55 / $214.10 / $313.70	Professional		$167.55	$214.10	$313.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.91 / $94.57 / $148.87	Professional	26	$73.91	$94.57	$148.87