Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.90 / $49.90 / $49.90	Facility		$49.90	$49.90	$49.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $49.90 / $77.80	Professional		$27.60	$49.90	$77.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $66.64 / $66.64	Professional		$62.20	$66.64	$66.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.53 / $224.42 / $778.60	Facility		$106.53	$224.42	$778.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.27 / $66.64 / $66.64	Professional		$57.27	$66.64	$66.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $59.47 / $97.74	Facility		$59.47	$59.47	$97.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $59.47 / $103.13	Professional		$43.41	$59.47	$103.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $97.74 / $170.85	Professional		$86.78	$97.74	$170.85
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 $115.51 / $115.51 / $115.51	Professional		$115.51	$115.51	$115.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.29 / $78.23 / $130.61	Professional		$42.29	$78.23	$130.61
United Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $44.32 / $78.48	Professional		$33.24	$44.32	$78.48