Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $154.88 / $288.40	Facility		$75.86	$154.88	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $346.74	Professional		$109.65	$162.18	$346.74
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $131.83 / $676.08 / $676.08	Professional	25	$131.83	$676.08	$676.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $512.86 / $512.86 / $512.86	Professional	52	$512.86	$512.86	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $181.97	Professional		$102.33	$134.90	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $645.65 / $645.65	Facility		$229.09	$645.65	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $229.09	Professional		$138.04	$194.98	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $245.47	Facility		$181.97	$181.97	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $239.88	Professional		$89.13	$147.91	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $281.84	Professional		$134.90	$194.98	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $467.74 / $616.60	Facility		$83.18	$467.74	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $245.47	Professional		$112.20	$162.18	$245.47