Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $114.82 / $131.83	Facility		$104.71	$114.82	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $218.78	Professional		$56.23	$79.43	$218.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $120.23 / $245.47	Professional	25	$58.88	$120.23	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $117.49	Professional		$54.95	$67.61	$117.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $69.18 / $77.62 / $91.20	Professional	25	$69.18	$77.62	$91.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $144.54	Professional		$64.57	$95.50	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $239.88	Professional		$72.44	$114.82	$239.88
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 $85.11 / $89.13 / $95.50	Professional		$85.11	$89.13	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $128.82	Professional		$64.57	$87.10	$128.82