Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.86 / $147.81 / $316.45	Facility		$110.86	$147.81	$316.45
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $256.80 / $256.80 / $469.60	Facility	25	$256.80	$256.80	$469.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.64 / $195.28 / $442.01	Professional		$125.64	$195.28	$442.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.06 / $205.02 / $240.68	Professional		$159.06	$205.02	$240.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $342.93 / $736.36 / $2,622.98	Facility		$342.93	$736.36	$2,622.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.30 / $190.51 / $197.73	Professional		$190.30	$190.51	$197.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.30 / $240.68 / $361.64	Professional		$166.30	$240.68	$361.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $178.28 / $258.43 / $513.70	Professional		$178.28	$258.43	$513.70
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 $197.00 / $207.01 / $231.76	Professional		$197.00	$207.01	$231.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $242.46	Professional		$32.34	$32.34	$242.46
United Facility/Professional Professional Modifier Low / Median / High Price $168.11 / $224.77 / $376.01	Professional		$168.11	$224.77	$376.01