Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.72 / $80.72 / $547.55	Facility		$80.72	$80.72	$547.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $84.35 / $125.11	Professional		$63.16	$84.35	$125.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.79 / $117.79 / $117.79	Professional		$117.79	$117.79	$117.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.62 / $317.42 / $1,351.27	Facility		$187.62	$317.42	$1,351.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $119.36 / $119.36	Professional		$88.19	$119.36	$119.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $102.60 / $197.59	Facility		$102.60	$102.60	$197.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $102.60 / $182.25	Professional		$74.90	$102.60	$182.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $135.74 / $189.11 / $221.91	Professional		$135.74	$189.11	$221.91
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 $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.86 / $118.38 / $124.29	Professional		$82.86	$118.38	$124.29
United Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $78.34 / $138.75	Professional		$64.01	$78.34	$138.75