Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $97.72 / $97.72	Facility	26	$61.66	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $245.47	Professional		$107.15	$141.25	$245.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $204.17	Professional		$67.61	$125.89	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $269.15	Professional		$102.33	$165.96	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $4,265.80	Professional		$117.49	$190.55	$4,265.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $95.50 / $2,630.27	Professional	26	$60.26	$95.50	$2,630.27
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 $147.91 / $151.36 / $162.18	Professional		$147.91	$151.36	$162.18
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 $107.15 / $151.36 / $263.03	Professional		$107.15	$151.36	$263.03