Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.07 / $49.32 / $98.69	Facility		$28.07	$49.32	$98.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.64 / $18.04 / $28.39	Professional		$15.64	$18.04	$28.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $30.08 / $30.08	Professional		$30.08	$30.08	$30.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.07 / $63.00 / $315.77	Facility		$28.07	$63.00	$315.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $13.83 / $20.05	Professional		$3.50	$13.83	$20.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.34 / $48.62 / $92.32	Facility		$25.34	$48.62	$92.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.26 / $24.52 / $41.93	Professional		$10.26	$24.52	$41.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $22.16 / $39.22 / $121.65	Professional		$22.16	$39.22	$121.65
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 $26.07 / $26.07 / $26.07	Professional		$26.07	$26.07	$26.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $27.27 / $30.08	Professional		$10.52	$27.27	$30.08
United Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $13.62 / $28.02	Professional		$8.42	$13.62	$28.02