Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.70 / $152.49 / $201.21	Facility		$83.70	$152.49	$201.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.17 / $134.25 / $301.74	Professional		$79.17	$134.25	$301.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.42 / $131.80 / $177.39	Professional		$105.42	$131.80	$177.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.20 / $360.79 / $360.79	Facility		$251.20	$360.79	$360.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.63 / $136.03 / $185.06	Professional		$104.63	$136.03	$185.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.60 / $125.60 / $136.10	Facility		$125.60	$125.60	$136.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.33 / $143.77 / $215.11	Professional		$91.33	$143.77	$215.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.80 / $171.91 / $313.05	Professional		$108.80	$171.91	$313.05
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 $112.72 / $117.05 / $171.91	Professional		$112.72	$117.05	$171.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.61 / $66.40 / $194.39	Professional		$64.61	$66.40	$194.39
United Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $148.87 / $248.78	Professional		$115.83	$148.87	$248.78