Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.12 / $253.13 / $456.47	Facility		$155.12	$253.13	$456.47
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $166.88 / $166.88 / $170.86	Facility	25	$166.88	$166.88	$170.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.34 / $228.01 / $379.71	Professional		$154.34	$228.01	$379.71
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $210.64 / $300.82 / $502.21	Professional	25	$210.64	$300.82	$502.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.02 / $384.37 / $384.37	Professional		$232.02	$384.37	$384.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.32 / $1,387.90 / $3,228.69	Facility		$177.32	$1,387.90	$3,228.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.54 / $277.35 / $326.29	Professional		$207.54	$277.35	$326.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.63 / $288.58 / $435.73	Professional		$211.63	$288.58	$435.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $177.75 / $301.92 / $554.20	Professional		$177.75	$301.92	$554.20
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 $227.50 / $235.05 / $370.14	Professional		$227.50	$235.05	$370.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $418.54	Professional		$32.34	$32.34	$418.54
United Facility/Professional Professional Modifier Low / Median / High Price $210.85 / $306.68 / $447.44	Professional		$210.85	$306.68	$447.44