Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.62 / $193.58 / $288.83	Facility		$96.62	$193.58	$288.83
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $189.40 / $264.00 / $336.89	Facility	25	$189.40	$264.00	$336.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.18 / $170.13 / $394.53	Professional		$97.18	$170.13	$394.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.10 / $202.79 / $457.70	Professional	25	$120.10	$202.79	$457.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.41 / $171.69 / $227.27	Professional		$138.41	$171.69	$227.27
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $145.93 / $173.49 / $227.27	Professional	25	$145.93	$173.49	$227.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.68 / $126.68 / $126.68	Facility		$126.68	$126.68	$126.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.38 / $175.72 / $190.77	Professional		$141.38	$175.72	$190.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $178.29	Facility		$120.00	$150.00	$178.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.41 / $193.12 / $288.14	Professional		$126.41	$193.12	$288.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.74 / $231.78 / $380.13	Professional		$147.74	$231.78	$380.13
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 $158.94 / $191.71 / $225.54	Professional		$158.94	$191.71	$225.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $255.03	Professional		$32.34	$32.34	$255.03
United Facility/Professional Facility Modifier Low / Median / High Price $188.95 / $188.95 / $188.95	Facility		$188.95	$188.95	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $142.68 / $194.29 / $308.91	Professional		$142.68	$194.29	$308.91