Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $367.72 / $367.72 / $367.72	Facility		$367.72	$367.72	$367.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.77 / $293.12 / $517.51	Professional		$220.77	$293.12	$517.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $102.50 / $142.59 / $171.35	Professional	52	$102.50	$142.59	$171.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.71 / $276.55 / $348.58	Professional		$251.71	$276.55	$348.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $695.62 / $980.04 / $1,344.52	Facility		$695.62	$980.04	$1,344.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.52 / $329.85 / $436.75	Professional		$302.52	$329.85	$436.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $333.08 / $333.08 / $333.08	Facility		$333.08	$333.08	$333.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.50 / $353.15 / $552.12	Professional		$238.50	$353.15	$552.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $308.93 / $438.39 / $757.14	Professional		$308.93	$438.39	$757.14
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 $355.16 / $364.61 / $389.06	Professional		$355.16	$364.61	$389.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $439.94	Professional		$32.34	$32.34	$439.94
United Facility/Professional Professional Modifier Low / Median / High Price $218.71 / $295.89 / $478.85	Professional		$218.71	$295.89	$478.85