Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $291.00 / $393.31 / $590.54	Facility	26	$291.00	$393.31	$590.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $839.60 / $1,069.41 / $1,524.95	Professional		$839.60	$1,069.41	$1,524.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $235.32 / $291.00 / $558.89	Professional	26	$235.32	$291.00	$558.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $218.32 / $218.32 / $218.32	Professional	26	$218.32	$218.32	$218.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.79 / $867.02 / $1,741.10	Professional		$282.79	$867.02	$1,741.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.78 / $1,277.19 / $1,771.94	Professional		$915.78	$1,277.19	$1,771.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $256.39 / $364.47 / $511.40	Professional	26	$256.39	$364.47	$511.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $867.23 / $1,261.68 / $3,888.48	Professional		$867.23	$1,261.68	$3,888.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.41 / $369.58 / $1,438.35	Professional	26	$257.41	$369.58	$1,438.35
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 $1,024.91 / $1,025.11 / $1,145.33	Professional		$1,024.91	$1,025.11	$1,145.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $266.19 / $300.29 / $331.50	Professional	26	$266.19	$300.29	$331.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $346.80 / $1,198.20	Professional		$32.34	$346.80	$1,198.20
United Facility/Professional Professional Modifier Low / Median / High Price $926.26 / $1,385.33 / $2,195.96	Professional		$926.26	$1,385.33	$2,195.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $250.10 / $385.50 / $585.98	Professional	26	$250.10	$385.50	$585.98