Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $107.15 / $199.53	Facility		$97.72	$107.15	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $151.36	Professional		$50.12	$97.72	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $93.33 / $109.65	Professional		$25.12	$93.33	$109.65
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 $97.72 / $128.82 / $194.98	Professional		$97.72	$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 $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
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 $97.72 / $102.33 / $117.49	Professional		$97.72	$102.33	$117.49