Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.20 / $205.01 / $333.31	Facility		$105.20	$205.01	$333.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $105.20 / $164.98	Professional		$67.98	$105.20	$164.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.19 / $173.19 / $173.19	Professional		$173.19	$173.19	$173.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.75 / $684.61 / $1,697.04	Facility		$175.75	$684.61	$1,697.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $88.52 / $98.78	Professional		$3.50	$88.52	$98.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.86 / $313.85 / $591.16	Facility		$162.86	$313.85	$591.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $156.29 / $245.66	Professional		$65.68	$156.29	$245.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.53 / $218.09 / $412.13	Professional		$131.53	$218.09	$412.13
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 $166.78 / $166.78 / $166.78	Professional		$166.78	$166.78	$166.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $174.47 / $174.47 / $192.44	Professional		$174.47	$174.47	$192.44
United Facility/Professional Professional Modifier Low / Median / High Price $53.88 / $81.72 / $149.81	Professional		$53.88	$81.72	$149.81