Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.74 / $115.46 / $115.99	Facility		$104.74	$115.46	$115.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.83 / $65.45 / $109.46	Professional		$51.83	$65.45	$109.46
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $57.45 / $105.60 / $209.60	Professional	25	$57.45	$105.60	$209.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $89.46 / $98.08	Professional		$64.84	$89.46	$98.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.80 / $118.80 / $118.80	Facility		$118.80	$118.80	$118.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $49.83	Professional		$40.00	$40.00	$49.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $94.80 / $94.80	Facility		$94.80	$94.80	$94.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.97 / $98.52 / $134.38	Professional		$68.97	$98.52	$134.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $102.06 / $224.50	Professional		$75.17	$102.06	$224.50
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 $85.22 / $88.45 / $94.87	Professional		$85.22	$88.45	$94.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $107.28	Professional		$32.34	$32.34	$107.28
United Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $90.98 / $140.16	Professional		$68.33	$90.98	$140.16
United Facility/Professional Professional Modifier 25 Low / Median / High Price $94.07 / $94.07 / $94.07	Professional	25	$94.07	$94.07	$94.07