Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.32 / $56.32 / $56.32	Facility		$56.32	$56.32	$56.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $56.32 / $81.87	Professional		$40.15	$56.32	$81.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.19 / $82.19 / $82.19	Professional		$82.19	$82.19	$82.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.38 / $220.58 / $942.83	Facility		$130.38	$220.58	$942.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.46 / $83.28 / $83.28	Professional		$60.46	$83.28	$83.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $62.81 / $96.23	Facility		$62.81	$62.81	$96.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $62.81 / $127.13	Professional		$45.85	$62.81	$127.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $120.54 / $150.00	Professional		$91.77	$120.54	$150.00
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 $142.44 / $142.44 / $142.44	Professional		$142.44	$142.44	$142.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.82 / $82.60 / $86.73	Professional		$57.82	$82.60	$86.73
United Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $52.96 / $96.80	Professional		$36.36	$52.96	$96.80