Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.56 / $264.12 / $325.50	Facility		$127.56	$264.12	$325.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $190.57 / $267.55 / $453.71	Facility	25	$190.57	$267.55	$453.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.34 / $216.38 / $522.91	Professional		$130.34	$216.38	$522.91
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $177.14 / $307.79 / $709.75	Professional	25	$177.14	$307.79	$709.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.56 / $227.05 / $301.08	Professional		$184.56	$227.05	$301.08
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $195.37 / $229.84 / $301.08	Professional	25	$195.37	$229.84	$301.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.95 / $603.47 / $603.47	Facility		$123.95	$603.47	$603.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $232.67 / $252.75	Professional		$192.50	$232.67	$252.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $242.44	Facility		$120.00	$150.00	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.31 / $254.90 / $370.05	Professional		$164.31	$254.90	$370.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $192.84 / $305.12 / $529.30	Professional		$192.84	$305.12	$529.30
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 $215.89 / $253.97 / $298.79	Professional		$215.89	$253.97	$298.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $337.86	Professional		$32.34	$32.34	$337.86
United Facility/Professional Professional Modifier Low / Median / High Price $180.78 / $240.00 / $390.23	Professional		$180.78	$240.00	$390.23
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $90.00	Professional	25	$80.00	$88.00	$90.00