Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.43 / $91.45 / $168.03	Facility	26	$51.43	$91.45	$168.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.74 / $233.23 / $364.90	Professional		$202.74	$233.23	$364.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $250.16 / $553.53	Professional		$70.09	$250.16	$553.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.85 / $326.13 / $469.13	Professional		$224.85	$326.13	$469.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $250.87 / $395.47 / $1,121.81	Professional		$250.87	$395.47	$1,121.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.15 / $84.02 / $241.44	Professional	26	$58.15	$84.02	$241.44
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 $293.85 / $302.42 / $326.13	Professional		$293.85	$302.42	$326.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $82.33 / $341.18	Professional		$32.34	$82.33	$341.18
United Facility/Professional Professional Modifier Low / Median / High Price $230.52 / $292.85 / $450.89	Professional		$230.52	$292.85	$450.89