Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $489.78	Facility		$295.12	$295.12	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $331.13	Professional		$199.53	$275.42	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $16.60 / $25.12	Professional		$16.60	$16.60	$25.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $346.74	Professional		$154.88	$229.09	$346.74
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 $288.40 / $316.23 / $562.34	Facility		$288.40	$316.23	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $426.58	Professional		$223.87	$295.12	$426.58