Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $181.13 / $305.04	Facility	26	$100.00	$181.13	$305.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $113.40 / $266.14	Professional	26	$90.00	$113.40	$266.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $137.27 / $137.27 / $137.27	Professional	26	$137.27	$137.27	$137.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.38 / $142.36 / $236.91	Professional	26	$89.38	$142.36	$236.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.23 / $155.57 / $319.68	Professional	26	$106.23	$155.57	$319.68
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 26 Low / Median / High Price $122.47 / $125.54 / $132.18	Professional	26	$122.47	$125.54	$132.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.52 / $126.87 / $217.03	Professional	26	$99.52	$126.87	$217.03