Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $151.36 / $323.59	Facility		$61.66	$151.36	$323.59
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $91.20 / $218.78 / $436.52	Facility	25	$91.20	$218.78	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $288.40	Professional		$54.95	$120.23	$288.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $61.66 / $128.82 / $323.59	Professional	25	$61.66	$128.82	$323.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $95.50 / $309.03	Professional	50	$91.20	$95.50	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $165.96	Professional		$83.18	$117.49	$165.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $91.20 / $123.03 / $165.96	Professional	25	$91.20	$123.03	$165.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $169.82 / $323.59	Facility		$46.77	$169.82	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $144.54	Professional		$102.33	$117.49	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $134.90 / $158.49	Facility		$120.23	$134.90	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $208.93	Professional		$79.43	$128.82	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $269.15	Professional		$93.33	$158.49	$269.15
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 $117.49 / $144.54 / $169.82	Professional		$117.49	$144.54	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $93.33 / $125.89	Facility		$69.18	$93.33	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $165.96	Professional		$72.44	$107.15	$165.96