Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.59 / $216.51 / $403.22	Facility		$105.59	$216.51	$403.22
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $124.53 / $397.66 / $771.72	Facility	25	$124.53	$397.66	$771.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.98 / $162.16 / $390.65	Professional		$92.98	$162.16	$390.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $108.31 / $218.03 / $489.00	Professional	25	$108.31	$218.03	$489.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $183.81 / $249.74	Professional		$145.16	$183.81	$249.74
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $162.00 / $192.73 / $249.74	Professional	25	$162.00	$192.73	$249.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.36 / $414.26 / $472.73	Facility		$53.36	$414.26	$472.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $188.15 / $204.63	Professional		$151.22	$188.15	$204.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $191.64	Facility		$120.00	$150.00	$191.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.62 / $198.81 / $287.80	Professional		$119.62	$198.81	$287.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $240.49 / $403.96	Professional		$151.47	$240.49	$403.96
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 $172.17 / $204.41 / $240.49	Professional		$172.17	$204.41	$240.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $271.94	Professional		$32.34	$32.34	$271.94
United Facility/Professional Professional Modifier Low / Median / High Price $119.19 / $187.78 / $280.73	Professional		$119.19	$187.78	$280.73