Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $31.62 / $208.93	Facility		$19.95	$31.62	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $36.31	Professional		$15.85	$19.95	$36.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $14.79 / $25.70	Professional		$12.30	$14.79	$25.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $204.17 / $363.08	Facility		$165.96	$204.17	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $31.62	Professional		$22.91	$30.90	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $190.55 / $363.08	Facility		$173.78	$190.55	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $26.30 / $39.81	Professional		$18.20	$26.30	$39.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $40.74 / $72.44	Professional		$19.95	$40.74	$72.44
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 $23.99 / $23.99 / $26.92	Professional		$23.99	$23.99	$26.92
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 Facility Modifier Low / Median / High Price $199.53 / $354.81 / $467.74	Facility		$199.53	$354.81	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.44 / $35.48	Professional		$17.38	$23.44	$35.48