Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $169.82 / $309.03	Facility		$93.33	$169.82	$309.03
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $181.97 / $263.03 / $588.84	Facility	25	$181.97	$263.03	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $436.52	Professional		$102.33	$177.83	$436.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $114.82 / $199.53 / $467.74	Professional	25	$114.82	$199.53	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $223.87	Professional		$123.03	$162.18	$223.87
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $165.96 / $229.09	Professional	25	$128.82	$165.96	$229.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $190.55	Professional		$141.25	$158.49	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $141.25 / $162.18	Facility		$120.23	$141.25	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $302.00	Professional		$128.82	$186.21	$302.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $213.80 / $436.52	Professional		$138.04	$213.80	$436.52
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 $158.49 / $190.55 / $223.87	Professional		$158.49	$190.55	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $128.82 / $162.18	Facility		$69.18	$128.82	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $251.19	Professional		$117.49	$165.96	$251.19