Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.22 / $170.67 / $340.29	Facility		$58.22	$170.67	$340.29
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $90.72 / $250.56 / $334.03	Facility	25	$90.72	$250.56	$334.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $120.18 / $278.35	Professional		$65.00	$120.18	$278.35
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.69 / $134.72 / $310.89	Professional	25	$68.69	$134.72	$310.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $92.10 / $94.50 / $233.22	Professional	50	$92.10	$94.50	$233.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.62 / $124.19 / $177.00	Professional		$94.62	$124.19	$177.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.30 / $131.11 / $177.00	Professional	25	$100.30	$131.11	$177.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.89 / $287.83 / $322.18	Facility		$46.89	$287.83	$322.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $127.49 / $144.75	Professional		$102.44	$127.49	$144.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $135.00 / $155.00	Facility		$120.00	$135.00	$155.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.10 / $137.66 / $205.75	Professional		$82.10	$137.66	$205.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.15 / $170.67 / $277.27	Professional		$104.15	$170.67	$277.27
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 $116.22 / $145.74 / $171.46	Professional		$116.22	$145.74	$171.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $193.88	Professional		$32.34	$32.34	$193.88
United Facility/Professional Professional Modifier Low / Median / High Price $85.71 / $121.47 / $198.47	Professional		$85.71	$121.47	$198.47