Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.30 / $105.59 / $145.41	Facility	26	$60.30	$105.59	$145.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $119.67 / $210.74	Professional		$100.69	$119.67	$210.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.80 / $67.43 / $122.25	Professional	26	$58.80	$67.43	$122.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.86 / $133.24 / $153.10	Professional		$100.86	$133.24	$153.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.98 / $84.88 / $91.65	Professional	26	$57.98	$84.88	$91.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.54 / $112.75 / $156.49	Professional		$71.54	$112.75	$156.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $74.17 / $74.17	Facility	26	$74.17	$74.17	$74.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.65 / $155.44 / $253.73	Professional		$113.65	$155.44	$253.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.16 / $90.31 / $144.88	Professional	26	$67.16	$90.31	$144.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.26 / $165.24 / $455.23	Professional		$110.26	$165.24	$455.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.51 / $96.77 / $327.52	Professional	26	$64.51	$96.77	$327.52
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 $132.16 / $133.74 / $143.21	Professional		$132.16	$133.74	$143.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.87 / $79.43 / $83.86	Professional	26	$78.87	$79.43	$83.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.57 / $142.34	Professional		$32.34	$40.57	$142.34
United Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $176.26 / $286.49	Professional		$111.74	$176.26	$286.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $91.48 / $148.37	Professional	26	$62.37	$91.48	$148.37