Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.22 / $77.34 / $143.63	Facility		$26.22	$77.34	$143.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $33.70 / $43.39	Professional		$30.18	$33.70	$43.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.64 / $22.64 / $50.94	Professional		$22.64	$22.64	$50.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.70 / $120.74 / $396.53	Facility		$54.70	$120.74	$396.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $26.03 / $29.05	Professional		$3.50	$26.03	$29.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $92.11 / $174.22	Facility		$39.40	$92.11	$174.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $45.84 / $57.63	Professional		$27.18	$45.84	$57.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $60.37 / $176.09	Professional		$38.47	$60.37	$176.09
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 $49.05 / $49.05 / $49.05	Professional		$49.05	$49.05	$49.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $25.88 / $47.16	Professional		$16.60	$25.88	$47.16
United Facility/Professional Facility Modifier Low / Median / High Price $21.74 / $75.45 / $75.45	Facility		$21.74	$75.45	$75.45
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $22.64 / $44.06	Professional		$15.85	$22.64	$44.06