Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $85.11 / $169.82	Facility		$54.95	$85.11	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $199.53	Professional		$56.23	$109.65	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.79 / $199.53	Professional		$44.67	$70.79	$199.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $302.00 / $1,174.90	Facility		$151.36	$302.00	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $141.25	Professional		$69.18	$97.72	$141.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $346.74	Professional		$75.86	$125.89	$346.74
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 $85.11 / $87.10 / $93.33	Professional		$85.11	$87.10	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.88 / $93.33	Professional		$33.11	$33.88	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $141.25	Facility		$67.61	$67.61	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $91.20 / $138.04	Professional		$69.18	$91.20	$138.04