Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.79 / $57.71 / $298.82	Facility		$15.79	$57.71	$298.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.51 / $52.73 / $77.40	Professional		$34.51	$52.73	$77.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $65.78 / $96.48	Professional		$53.36	$65.78	$96.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.75 / $201.75 / $631.04	Facility		$117.75	$201.75	$631.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $52.36 / $52.36	Professional		$39.79	$52.36	$52.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.14 / $67.14 / $97.82	Facility		$67.14	$67.14	$97.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $67.14 / $78.75	Professional		$49.01	$67.14	$78.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.89 / $90.19 / $154.13	Professional		$68.89	$90.19	$154.13
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 $89.56 / $89.56 / $89.56	Professional		$89.56	$89.56	$89.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.79 / $29.70 / $31.18	Professional		$20.79	$29.70	$31.18
United Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $50.00 / $87.80	Professional		$39.93	$50.00	$87.80