Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.24 / $162.24 / $162.24	Facility		$162.24	$162.24	$162.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.29 / $104.92 / $157.37	Professional		$93.29	$104.92	$157.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $91.83 / $101.20	Professional		$89.87	$91.83	$101.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $336.32 / $356.11 / $589.55	Facility		$336.32	$356.11	$589.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $114.28 / $152.07	Professional		$105.34	$114.28	$152.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.35 / $575.00 / $1,779.00	Facility		$116.35	$575.00	$1,779.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.79 / $139.97 / $235.77	Professional		$100.79	$139.97	$235.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.17 / $156.26 / $378.30	Professional		$110.17	$156.26	$378.30
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 $122.73 / $126.96 / $134.80	Professional		$122.73	$126.96	$134.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $152.41	Professional		$32.34	$32.34	$152.41
United Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $128.79 / $208.30	Professional		$96.47	$128.79	$208.30