Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.21 / $193.89 / $335.34	Facility	26	$104.21	$193.89	$335.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.05 / $105.02 / $214.21	Professional	26	$97.05	$105.02	$214.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $134.13 / $134.13 / $134.13	Professional	26	$134.13	$134.13	$134.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.27 / $156.50 / $243.20	Professional	26	$101.27	$156.50	$243.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.37 / $189.77 / $644.91	Professional	26	$117.37	$189.77	$644.91
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 $131.31 / $137.06 / $145.31	Professional	26	$131.31	$137.06	$145.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.19 / $146.75 / $234.34	Professional	26	$116.19	$146.75	$234.34