Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.30 / $284.30 / $284.30	Facility		$284.30	$284.30	$284.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.78 / $202.54 / $342.31	Professional		$162.78	$202.54	$342.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.98 / $187.37 / $206.10	Professional		$172.98	$187.37	$206.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $507.62 / $674.48 / $1,042.13	Facility		$507.62	$674.48	$1,042.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.86 / $227.15 / $300.08	Professional		$207.86	$227.15	$300.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.74 / $228.74 / $228.74	Facility		$228.74	$228.74	$228.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.48 / $252.09 / $390.62	Professional		$175.48	$252.09	$390.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $216.41 / $309.14 / $556.04	Professional		$216.41	$309.14	$556.04
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 $245.60 / $250.52 / $267.93	Professional		$245.60	$250.52	$267.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $302.97	Professional		$32.34	$32.34	$302.97
United Facility/Professional Professional Modifier Low / Median / High Price $169.10 / $216.74 / $359.00	Professional		$169.10	$216.74	$359.00