Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.85 / $206.85 / $402.45	Facility		$206.85	$206.85	$402.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.52 / $206.85 / $321.95	Professional		$178.52	$206.85	$321.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $301.83 / $301.83 / $301.83	Professional		$301.83	$301.83	$301.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $480.18 / $812.38 / $3,462.83	Facility		$480.18	$812.38	$3,462.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.43 / $305.86 / $305.86	Professional		$257.43	$305.86	$305.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.60 / $252.60 / $518.78	Facility		$252.60	$252.60	$518.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.40 / $184.40 / $494.49	Professional		$184.40	$184.40	$494.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $342.08 / $471.62 / $567.37	Professional		$342.08	$471.62	$567.37
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 $523.19 / $523.19 / $523.19	Professional		$523.19	$523.19	$523.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $212.33 / $303.33 / $318.50	Professional		$212.33	$303.33	$318.50
United Facility/Professional Professional Modifier Low / Median / High Price $166.43 / $200.78 / $355.53	Professional		$166.43	$200.78	$355.53