Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $75.86 / $117.49	Facility		$47.86	$75.86	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $128.82	Professional		$48.98	$69.18	$128.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.45 / $70.79 / $75.86	Professional	25	$14.45	$70.79	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $77.62	Professional		$56.23	$67.61	$77.62
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $69.18 / $79.43	Professional	25	$63.10	$69.18	$79.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $288.40 / $1,096.48	Facility		$141.25	$288.40	$1,096.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $83.18 / $89.13	Professional		$81.28	$83.18	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $141.25	Professional		$72.44	$104.71	$141.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $194.98	Professional		$75.86	$109.65	$194.98
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 $89.13 / $91.20 / $97.72	Professional		$89.13	$91.20	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $87.10	Facility		$72.44	$72.44	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $128.82	Professional		$60.26	$79.43	$128.82