Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $151.36 / $251.19	Facility		$83.18	$151.36	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $363.08	Professional		$87.10	$162.18	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $169.82	Professional		$97.72	$120.23	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $363.08 / $407.38	Facility		$239.88	$363.08	$407.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $165.96	Professional		$104.71	$134.90	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $229.09	Professional		$91.20	$138.04	$229.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $309.03	Professional		$100.00	$165.96	$309.03
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 $112.20 / $117.49 / $165.96	Professional		$112.20	$117.49	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $42.66 / $190.55	Professional		$41.69	$42.66	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $120.23	Facility		$89.13	$89.13	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $190.55	Professional		$87.10	$123.03	$190.55