Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $891.25 / $1,318.26	Facility		$104.71	$891.25	$1,318.26
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $676.08 / $954.99 / $1,318.26	Facility	25	$676.08	$954.99	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $407.38	Professional		$85.11	$123.03	$407.38
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.72 / $218.78 / $575.44	Professional	25	$97.72	$218.78	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $199.53	Professional		$102.33	$134.90	$199.53
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $97.72 / $134.90 / $208.93	Professional	25	$97.72	$134.90	$208.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $489.78 / $630.96	Facility		$239.88	$489.78	$630.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $173.78	Professional		$138.04	$162.18	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $239.88	Professional		$107.15	$162.18	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $269.15 / $954.99	Professional		$120.23	$269.15	$954.99
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 $1,122.02 / $1,122.02 / $1,445.44	Facility		$1,122.02	$1,122.02	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $223.87	Professional		$104.71	$141.25	$223.87