Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.84 / $135.00 / $298.64	Facility		$46.84	$135.00	$298.64
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $96.98 / $180.32 / $278.98	Facility	25	$96.98	$180.32	$278.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.55 / $84.79 / $177.66	Professional		$48.55	$84.79	$177.66
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $55.14 / $91.76 / $200.13	Professional	25	$55.14	$91.76	$200.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.34 / $65.18 / $271.76	Professional	50	$38.34	$65.18	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $87.91 / $125.74	Professional		$64.75	$87.91	$125.74
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $71.12 / $90.36 / $122.54	Professional	25	$71.12	$90.36	$122.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.95 / $190.99 / $218.65	Facility		$33.95	$190.99	$218.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.55 / $87.39 / $102.81	Professional		$69.55	$87.39	$102.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $135.00 / $155.00	Facility		$75.00	$135.00	$155.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $94.06 / $143.12	Professional		$52.84	$94.06	$143.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $116.93 / $187.08	Professional		$69.98	$116.93	$187.08
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 $69.98 / $79.00 / $112.24	Professional		$69.98	$79.00	$112.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $140.31	Professional		$32.34	$32.34	$140.31
United Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $85.72 / $140.85	Professional		$62.42	$85.72	$140.85