Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $67.41 / $119.11	Facility		$42.13	$67.41	$119.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $42.13 / $84.26	Professional		$40.28	$42.13	$84.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.28 / $25.28 / $25.28	Professional		$25.28	$25.28	$25.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.90 / $42.13 / $67.81	Facility		$34.90	$42.13	$67.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $42.13 / $42.13	Professional		$3.50	$42.13	$42.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.22 / $100.76 / $193.58	Facility		$29.22	$100.76	$193.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $48.40 / $60.50	Professional		$42.13	$48.40	$60.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $65.88 / $150.34	Professional		$44.24	$65.88	$150.34
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 $54.77 / $54.77 / $54.77	Professional		$54.77	$54.77	$54.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $30.00 / $44.23	Professional		$22.12	$30.00	$44.23
United Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $25.28 / $43.39	Professional		$17.69	$25.28	$43.39