Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $95.50 / $194.98	Facility		$46.77	$95.50	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $190.55	Professional		$63.10	$97.72	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $89.13 / $125.89	Professional		$36.31	$89.13	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $194.98	Professional		$87.10	$128.82	$194.98
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 $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $102.33	Professional		$56.23	$56.23	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $138.04 / $138.04	Facility		$93.33	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $102.33	Professional		$87.10	$102.33	$102.33