Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $63.10 / $147.91	Facility		$30.20	$63.10	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $75.86 / $147.91	Professional		$28.18	$75.86	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $223.87 / $575.44	Facility		$104.71	$223.87	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $89.13 / $173.78	Professional		$45.71	$89.13	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $131.83 / $194.98	Facility		$97.72	$131.83	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $81.28 / $158.49	Professional		$30.90	$81.28	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $117.49 / $288.40	Professional		$36.31	$117.49	$288.40
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 $34.67 / $35.48 / $107.15	Professional		$34.67	$35.48	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $190.55 / $251.19	Facility		$107.15	$190.55	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $67.61 / $144.54	Professional		$29.51	$67.61	$144.54