Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $102.33 / $291.64	Facility		$78.37	$102.33	$291.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.47 / $102.33	Professional		$78.37	$78.47	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $78.47 / $78.47	Professional		$78.47	$78.47	$78.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.80 / $193.76 / $869.53	Facility		$100.80	$193.76	$869.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $96.60 / $96.60	Professional		$85.53	$96.60	$96.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $78.37 / $78.37	Facility		$78.37	$78.37	$78.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $100.22	Professional		$78.37	$78.37	$100.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.40 / $100.38 / $212.52	Professional		$69.40	$100.38	$212.52
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 $101.88 / $101.88 / $101.88	Professional		$101.88	$101.88	$101.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $108.53 / $116.28	Professional		$77.52	$108.53	$116.28
United Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $83.07 / $90.34	Professional		$78.37	$83.07	$90.34