Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.31 / $123.26 / $130.94	Facility		$111.31	$123.26	$130.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.64 / $76.65 / $133.38	Professional		$54.64	$76.65	$133.38
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $62.30 / $83.84 / $197.77	Professional	25	$62.30	$83.84	$197.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $80.39 / $94.56	Professional		$71.09	$80.39	$94.56
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $65.08 / $79.22 / $102.05	Professional	25	$65.08	$79.22	$102.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.30 / $148.50 / $181.30	Facility		$132.30	$148.50	$181.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $62.22	Professional		$50.00	$50.00	$62.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Facility		$100.27	$100.27	$100.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $108.88 / $148.38	Professional		$74.34	$108.88	$148.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $114.86 / $194.06	Professional		$84.89	$114.86	$194.06
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 $90.22 / $93.43 / $108.99	Professional		$90.22	$93.43	$108.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $125.76	Professional		$32.34	$32.34	$125.76
United Facility/Professional Professional Modifier Low / Median / High Price $78.28 / $105.01 / $162.77	Professional		$78.28	$105.01	$162.77
United Facility/Professional Professional Modifier 25 Low / Median / High Price $98.97 / $99.10 / $99.10	Professional	25	$98.97	$99.10	$99.10