Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $107.15 / $120.23	Facility	26	$69.18	$107.15	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $389.05	Professional		$141.25	$173.78	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $87.10 / $288.40	Professional	26	$63.10	$87.10	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $199.53	Professional		$120.23	$144.54	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $75.86 / $83.18	Professional	26	$67.61	$75.86	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $147.91 / $269.15	Professional		$75.86	$147.91	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $338.84	Professional		$147.91	$213.80	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $93.33 / $151.36	Professional	26	$67.61	$93.33	$151.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $724.44	Professional		$144.54	$234.42	$724.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $102.33 / $446.68	Professional	26	$69.18	$102.33	$446.68
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 Low / Median / High Price $186.21 / $186.21 / $204.17	Professional		$186.21	$186.21	$204.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $89.13	Professional	26	$81.28	$83.18	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $138.04	Professional		$32.36	$33.11	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $288.40	Professional		$141.25	$186.21	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $83.18 / $128.82	Professional	26	$61.66	$83.18	$128.82