Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.92 / $925.65 / $1,350.00	Facility		$121.92	$925.65	$1,350.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $651.52 / $951.84 / $1,350.00	Facility	25	$651.52	$951.84	$1,350.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $114.08 / $366.96	Professional		$78.84	$114.08	$366.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $112.64 / $237.30 / $720.64	Professional	25	$112.64	$237.30	$720.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.81 / $154.25 / $415.16	Professional		$114.81	$154.25	$415.16
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.34 / $158.69 / $428.50	Professional	25	$114.34	$158.69	$428.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.21 / $491.86 / $609.01	Facility		$240.21	$491.86	$609.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.52 / $161.79 / $175.86	Professional		$137.52	$161.79	$175.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $155.00	Facility		$139.63	$139.63	$155.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $165.76 / $235.03	Professional		$104.40	$165.76	$235.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $189.44 / $875.78	Professional		$125.51	$189.44	$875.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $186.75	Professional		$32.34	$32.34	$186.75
United Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $146.38 / $237.35	Professional		$107.71	$146.38	$237.35