Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $144.54 / $239.88	Facility		$97.72	$144.54	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $218.78	Professional		$100.00	$131.83	$218.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $30.20 / $125.89 / $125.89	Professional	25	$30.20	$125.89	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $158.49	Professional		$114.82	$134.90	$158.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $117.49 / $123.03 / $147.91	Professional	25	$117.49	$123.03	$147.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $562.34 / $2,187.76	Facility		$275.42	$562.34	$2,187.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $173.78 / $186.21	Professional		$169.82	$173.78	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $213.80 / $245.47	Professional		$107.15	$213.80	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $389.05	Professional		$154.88	$218.78	$389.05
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 $186.21 / $190.55 / $204.17	Professional		$186.21	$190.55	$204.17
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 $147.91 / $147.91 / $154.88	Facility		$147.91	$147.91	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $245.47	Professional		$114.82	$151.36	$245.47