Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.62 / $99.12 / $171.05	Facility		$28.62	$99.12	$171.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.81 / $17.71 / $27.05	Professional		$12.81	$17.71	$27.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.32 / $11.82 / $26.60	Professional		$5.32	$11.82	$26.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.56 / $63.11 / $207.07	Facility		$28.56	$63.11	$207.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $13.59 / $15.17	Professional		$3.50	$13.59	$15.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.51 / $47.76 / $90.83	Facility		$20.51	$47.76	$90.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $23.95 / $30.01	Professional		$12.82	$23.95	$30.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $34.47 / $120.00	Professional		$20.09	$34.47	$120.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $25.61 / $25.61	Professional		$25.61	$25.61	$25.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $13.51 / $24.63	Professional		$7.24	$13.51	$24.63
United Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $12.60 / $19.70	Professional		$8.27	$12.60	$19.70