Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $147.91 / $208.93	Facility		$77.62	$147.91	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $295.12	Professional		$72.44	$114.82	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $186.21	Professional		$87.10	$109.65	$186.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $263.03 / $416.87	Facility		$239.88	$263.03	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $151.36 / $239.88	Facility		$141.25	$151.36	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $213.80	Professional		$91.20	$134.90	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $407.38	Professional		$97.72	$147.91	$407.38
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 $107.15 / $109.65 / $147.91	Professional		$107.15	$109.65	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $162.18	Professional		$32.36	$51.29	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $85.11 / $109.65	Facility		$64.57	$85.11	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $190.55	Professional		$89.13	$125.89	$190.55