Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.54 / $194.54 / $640.38	Facility		$194.54	$194.54	$640.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.25 / $203.06 / $565.09	Professional		$173.25	$203.06	$565.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $283.87 / $283.87 / $283.87	Professional		$283.87	$283.87	$283.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $451.56 / $763.96 / $3,256.55	Facility		$451.56	$763.96	$3,256.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.95 / $287.64 / $287.64	Professional		$243.95	$287.64	$287.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.27 / $211.27 / $414.30	Facility		$211.27	$211.27	$414.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.22 / $165.48 / $438.75	Professional		$154.22	$165.48	$438.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $302.79 / $378.49 / $497.73	Professional		$302.79	$378.49	$497.73
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 $492.04 / $492.04 / $492.04	Professional		$492.04	$492.04	$492.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.32 / $213.66 / $320.50	Professional		$110.32	$213.66	$320.50
United Facility/Professional Professional Modifier Low / Median / High Price $140.57 / $188.83 / $393.39	Professional		$140.57	$188.83	$393.39