Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $141.25 / $302.00	Facility		$63.10	$141.25	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $147.91	Professional		$54.95	$66.07	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $147.91	Professional		$77.62	$125.89	$147.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $234.42 / $794.33	Facility		$151.36	$234.42	$794.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $93.33	Professional		$70.79	$93.33	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $89.13 / $89.13	Facility		$83.18	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $125.89	Professional		$64.57	$64.57	$125.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $173.78	Professional		$97.72	$125.89	$173.78
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 $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $138.04	Professional		$97.72	$97.72	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $100.00 / $181.97	Facility		$46.77	$100.00	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $93.33	Professional		$45.71	$61.66	$93.33