Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $85.11 / $239.88	Facility		$30.20	$85.11	$239.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $81.28 / $107.15 / $295.12	Facility	25	$81.28	$107.15	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $123.03	Professional		$28.84	$53.70	$123.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $60.26 / $131.83	Professional	25	$32.36	$60.26	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $74.13	Professional		$30.90	$52.48	$74.13
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $41.69 / $54.95 / $72.44	Professional	25	$41.69	$54.95	$72.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $117.49 / $131.83	Facility		$27.54	$117.49	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $64.57	Professional		$37.15	$48.98	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $125.89 / $158.49	Facility		$42.66	$125.89	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $50.12 / $87.10	Professional		$29.51	$50.12	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $67.61 / $114.82	Professional		$37.15	$67.61	$114.82
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 $42.66 / $63.10 / $74.13	Professional		$42.66	$63.10	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $48.98 / $54.95	Facility		$33.88	$48.98	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $69.18	Professional		$25.12	$41.69	$69.18