Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.70 / $127.81 / $176.53	Facility		$74.70	$127.81	$176.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.93 / $104.19 / $195.97	Professional		$64.93	$104.19	$195.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.46 / $127.84 / $156.90	Professional		$108.46	$127.84	$156.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $232.36 / $301.08 / $327.35	Facility		$232.36	$301.08	$327.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $117.41 / $163.62	Professional		$86.78	$117.41	$163.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.52 / $104.52 / $125.21	Facility		$104.52	$104.52	$125.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $122.03 / $191.63	Professional		$78.14	$122.03	$191.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $92.98 / $151.09 / $255.39	Professional		$92.98	$151.09	$255.39
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 $94.03 / $97.25 / $151.09	Professional		$94.03	$97.25	$151.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $32.15 / $170.84	Professional		$31.28	$32.15	$170.84
United Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $133.65 / $222.12	Professional		$102.85	$133.65	$222.12