Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $147.91 / $251.19	Facility	26	$79.43	$147.91	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $295.12	Professional		$114.82	$141.25	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $194.98 / $309.03	Professional		$104.71	$194.98	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $275.42	Professional		$117.49	$190.55	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $851.14	Professional		$138.04	$281.84	$851.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $177.83 / $562.34	Professional	26	$87.10	$177.83	$562.34
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 $162.18 / $162.18 / $177.83	Professional		$162.18	$162.18	$177.83
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 $141.25 / $181.97 / $257.04	Professional		$141.25	$181.97	$257.04