Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $257.04	Facility		$38.02	$38.02	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $75.86	Professional		$26.92	$38.02	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $74.13	Professional		$30.90	$52.48	$74.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $144.54 / $512.86	Facility		$89.13	$144.54	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $56.23 / $56.23	Professional		$38.90	$56.23	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $50.12	Facility		$48.98	$48.98	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $75.86	Professional		$35.48	$35.48	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $104.71	Professional		$58.88	$74.13	$104.71
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 $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $56.23	Professional		$38.90	$38.90	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $58.88 / $97.72	Facility		$25.70	$58.88	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $52.48	Professional		$25.12	$37.15	$52.48