Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $151.36 / $263.03	Facility		$87.10	$151.36	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $354.81	Professional		$91.20	$169.82	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $177.83	Professional		$107.15	$131.83	$177.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $371.54 / $457.09	Facility		$269.15	$371.54	$457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $177.83	Professional		$109.65	$141.25	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $251.19	Professional		$97.72	$147.91	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $331.13	Professional		$107.15	$177.83	$331.13
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 $117.49 / $123.03 / $177.83	Professional		$117.49	$123.03	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $42.66 / $204.17	Professional		$41.69	$42.66	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $131.83	Facility		$95.50	$95.50	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $204.17	Professional		$93.33	$131.83	$204.17