Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.35 / $189.50 / $278.08	Facility		$181.35	$189.50	$278.08
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $193.30 / $343.72 / $343.72	Facility	25	$193.30	$343.72	$343.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.37 / $166.56 / $283.73	Professional		$136.37	$166.56	$283.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $168.77 / $210.35 / $261.45	Professional	25	$168.77	$210.35	$261.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $163.99 / $210.80	Professional		$150.59	$163.99	$210.80
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $152.76 / $157.90 / $227.89	Professional	25	$152.76	$157.90	$227.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $222.12 / $625.39 / $625.39	Facility		$222.12	$625.39	$625.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.15 / $219.87 / $263.95	Professional		$181.15	$219.87	$263.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $195.17	Professional		$147.60	$147.60	$195.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.88 / $208.23 / $383.04	Professional		$149.88	$208.23	$383.04
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 $200.10 / $203.00 / $218.31	Professional		$200.10	$203.00	$218.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $246.86	Professional		$32.34	$32.34	$246.86
United Facility/Professional Professional Modifier Low / Median / High Price $157.13 / $212.63 / $321.27	Professional		$157.13	$212.63	$321.27