Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $131.83	Facility		$66.07	$66.07	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $125.89	Professional		$56.23	$67.61	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $251.19 / $891.25	Facility		$154.88	$251.19	$891.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $97.72	Professional		$77.62	$97.72	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $181.97	Facility		$77.62	$77.62	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $151.36	Professional		$56.23	$56.23	$151.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $181.97	Professional		$109.65	$144.54	$181.97
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 $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $97.72	Professional		$67.61	$67.61	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $102.33 / $199.53	Facility		$51.29	$102.33	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $107.15	Professional		$48.98	$64.57	$107.15