Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $288.40	Facility		$177.83	$177.83	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $199.53	Professional		$117.49	$165.96	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Professional		$33.11	$33.11	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $229.09 / $302.00	Professional		$100.00	$229.09	$302.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $186.21 / $338.84	Facility		$169.82	$186.21	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $302.00	Professional		$131.83	$177.83	$302.00