Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $107.15 / $257.04	Facility		$51.29	$107.15	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $138.04	Professional		$38.90	$57.54	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $51.29	Professional		$31.62	$39.81	$51.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $173.78 / $676.08	Facility		$93.33	$173.78	$676.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $120.23	Professional		$43.65	$79.43	$120.23
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 $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
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 $47.86 / $64.57 / $64.57	Facility		$47.86	$64.57	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $60.26	Professional		$50.12	$58.88	$60.26