Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.71 / $183.61 / $238.69	Facility		$137.71	$183.61	$238.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.30 / $166.77 / $256.00	Professional		$125.30	$166.77	$256.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $216.97	Professional	25	$172.37	$172.37	$216.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.24 / $187.93 / $251.06	Professional		$132.24	$187.93	$251.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $726.78 / $726.78 / $726.78	Facility		$726.78	$726.78	$726.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.49 / $209.75 / $254.57	Professional		$155.49	$209.75	$254.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.00 / $280.49 / $280.49	Facility		$183.00	$280.49	$280.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $196.25 / $316.50	Professional		$75.00	$196.25	$316.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.78 / $220.94 / $374.04	Professional		$151.78	$220.94	$374.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $124.44 / $292.88	Professional		$32.34	$124.44	$292.88
United Facility/Professional Professional Modifier Low / Median / High Price $118.82 / $182.70 / $325.66	Professional		$118.82	$182.70	$325.66