Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $302.24	Facility		$63.75	$63.75	$302.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $66.64 / $121.33	Professional		$53.00	$66.64	$121.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.67 / $88.67 / $88.67	Professional		$88.67	$88.67	$88.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $157.53 / $293.43 / $1,094.55	Facility		$157.53	$293.43	$1,094.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.47 / $94.27 / $94.27	Professional		$71.47	$94.27	$94.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.27 / $88.85 / $124.04	Facility		$83.27	$88.85	$124.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $84.33 / $143.63	Professional		$64.86	$84.33	$143.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $99.23 / $127.13 / $173.66	Professional		$99.23	$127.13	$173.66
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 $161.25 / $161.25 / $161.25	Professional		$161.25	$161.25	$161.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.67 / $138.11 / $145.01	Professional		$96.67	$138.11	$145.01
United Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $61.88 / $106.22	Professional		$46.13	$61.88	$106.22