Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.65 / $138.83 / $219.30	Facility		$58.65	$138.83	$219.30
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $96.76 / $166.61 / $233.31	Facility	25	$96.76	$166.61	$233.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.86 / $106.95 / $256.17	Professional		$63.86	$106.95	$256.17
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.00 / $130.37 / $277.63	Professional	25	$76.00	$130.37	$277.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.93 / $114.75 / $154.91	Professional		$93.93	$114.75	$154.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $95.74 / $115.84 / $151.75	Professional	25	$95.74	$115.84	$151.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.89 / $279.06 / $279.06	Facility		$46.89	$279.06	$279.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $108.31 / $127.38	Professional		$87.03	$108.31	$127.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $135.00 / $155.00	Facility		$109.51	$135.00	$155.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.88 / $123.00 / $189.23	Professional		$79.88	$123.00	$189.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $149.18 / $256.39	Professional		$95.11	$149.18	$256.39
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 $87.58 / $97.28 / $138.32	Professional		$87.58	$97.28	$138.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $170.28	Professional		$32.34	$32.34	$170.28
United Facility/Professional Professional Modifier Low / Median / High Price $92.89 / $123.76 / $200.98	Professional		$92.89	$123.76	$200.98