Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.97 / $339.64 / $465.05	Facility		$162.97	$339.64	$465.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.37 / $162.97 / $198.74	Professional		$99.37	$162.97	$198.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $119.24 / $119.24	Professional		$119.24	$119.24	$119.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.89 / $47.60 / $319.97	Facility		$18.89	$47.60	$319.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $113.28 / $129.18	Professional		$3.50	$113.28	$129.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.52 / $475.38 / $914.29	Facility		$101.52	$475.38	$914.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.16 / $217.07 / $274.69	Professional		$60.16	$217.07	$274.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $178.87 / $289.27 / $733.19	Professional		$178.87	$289.27	$733.19
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 $258.36 / $258.36 / $258.36	Professional		$258.36	$258.36	$258.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.37 / $136.34 / $248.43	Professional		$99.37	$136.34	$248.43
United Facility/Professional Professional Modifier Low / Median / High Price $83.47 / $99.62 / $198.74	Professional		$83.47	$99.62	$198.74