Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $199.80 / $243.00	Facility		$85.00	$199.80	$243.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $192.28 / $254.49 / $254.49	Facility	25	$192.28	$254.49	$254.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.87 / $128.80 / $211.81	Professional		$91.87	$128.80	$211.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $110.41 / $147.37 / $207.12	Professional	25	$110.41	$147.37	$207.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.42 / $122.42 / $122.42	Professional	52	$122.42	$122.42	$122.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.32 / $132.13 / $178.97	Professional		$119.32	$132.13	$178.97
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $119.96 / $122.89 / $178.68	Professional	25	$119.96	$122.89	$178.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.77 / $487.13 / $487.13	Facility		$174.77	$487.13	$487.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.01 / $173.57 / $207.56	Professional		$143.01	$173.57	$207.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $153.83	Professional		$116.36	$116.36	$153.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.71 / $164.39 / $308.85	Professional		$118.71	$164.39	$308.85
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 $157.38 / $159.61 / $172.34	Professional		$157.38	$159.61	$172.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $194.88	Professional		$32.34	$32.34	$194.88
United Facility/Professional Professional Modifier Low / Median / High Price $105.56 / $142.71 / $214.49	Professional		$105.56	$142.71	$214.49