Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.17 / $90.46 / $99.03	Facility	26	$54.17	$90.46	$99.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.79 / $355.30 / $593.73	Professional		$275.79	$355.30	$593.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $56.95 / $104.38	Professional	26	$50.40	$56.95	$104.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $308.38 / $310.83 / $423.73	Professional		$308.38	$310.83	$423.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.92 / $66.79 / $75.14	Professional	26	$57.92	$66.79	$75.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $201.40 / $531.27	Professional		$61.73	$201.40	$531.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.04 / $468.21 / $707.40	Professional		$239.04	$468.21	$707.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $77.92 / $124.30	Professional	26	$56.86	$77.92	$124.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $310.45 / $476.87 / $820.28	Professional		$310.45	$476.87	$820.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.55 / $82.56 / $189.68	Professional	26	$57.55	$82.56	$189.68
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 $405.18 / $419.17 / $450.87	Professional		$405.18	$419.17	$450.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $68.45 / $72.36	Professional	26	$67.70	$68.45	$72.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.65 / $436.74	Professional		$32.34	$52.65	$436.74
United Facility/Professional Professional Modifier Low / Median / High Price $272.94 / $402.41 / $681.34	Professional		$272.94	$402.41	$681.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $82.46 / $132.74	Professional	26	$53.27	$82.46	$132.74