Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $295.12	Facility		$190.55	$190.55	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $208.93	Professional		$190.55	$190.55	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $346.74	Professional		$173.78	$218.78	$346.74
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 $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $269.15 / $269.15	Facility		$169.82	$269.15	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $204.17	Professional		$169.82	$199.53	$204.17