Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $102.33 / $169.82	Facility		$75.86	$102.33	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $295.12	Professional		$75.86	$117.49	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $151.36	Professional		$95.50	$114.82	$151.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $380.19 / $1,548.82	Facility		$181.97	$380.19	$1,548.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $131.83	Professional		$128.82	$128.82	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $223.87	Professional		$100.00	$144.54	$223.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $446.68	Professional		$114.82	$186.21	$446.68
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 $134.90 / $141.25 / $158.49	Professional		$134.90	$141.25	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $190.55	Professional		$89.13	$117.49	$190.55