Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $120.23 / $204.17	Facility	26	$63.10	$120.23	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $489.78	Professional		$229.09	$295.12	$489.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $302.00 / $588.84	Professional		$85.11	$302.00	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $398.11 / $630.96	Professional		$245.47	$398.11	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $426.58 / $1,548.82	Professional		$263.03	$426.58	$1,548.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $426.58	Professional	26	$70.79	$109.65	$426.58
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 $309.03 / $316.23 / $338.84	Professional		$309.03	$316.23	$338.84
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 $295.12 / $389.05 / $575.44	Professional		$295.12	$389.05	$575.44