Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $114.82	Professional		$30.20	$41.69	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $67.61	Professional		$33.88	$42.66	$67.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $75.86	Professional		$42.66	$67.61	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $199.53	Professional		$87.10	$107.15	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $67.61 / $263.03	Professional		$37.15	$67.61	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $45.71 / $50.12	Professional		$44.67	$45.71	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $53.70 / $91.20	Professional		$32.36	$53.70	$91.20