Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.06 / $85.40 / $221.84	Facility		$36.06	$85.40	$221.84
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $80.80 / $99.18 / $136.80	Facility	25	$80.80	$99.18	$136.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $49.71 / $114.21	Professional		$25.87	$49.71	$114.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.29 / $60.64 / $136.04	Professional	25	$33.29	$60.64	$136.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.86 / $40.86 / $40.86	Professional	50	$40.86	$40.86	$40.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $52.69 / $71.50	Professional		$37.47	$52.69	$71.50
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $48.88 / $53.19 / $72.45	Professional	25	$48.88	$53.19	$72.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.48 / $118.32 / $129.12	Facility		$27.48	$118.32	$129.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $52.63 / $64.08	Professional		$37.03	$52.63	$64.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.99 / $135.00 / $155.00	Facility		$46.99	$135.00	$155.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $29.37 / $29.37 / $29.37	Facility	62	$29.37	$29.37	$29.37
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $4.70 / $4.70 / $4.70	Facility	AS	$4.70	$4.70	$4.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.94 / $53.38 / $88.66	Professional		$30.94	$53.38	$88.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $72.84 / $114.94	Professional		$41.57	$72.84	$114.94
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 $42.20 / $63.54 / $74.75	Professional		$42.20	$63.54	$74.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $86.25	Professional		$32.34	$32.34	$86.25
United Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $54.01 / $87.41	Professional		$39.22	$54.01	$87.41