Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.89 / $208.50 / $658.86	Facility		$107.89	$208.50	$658.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.35 / $109.38 / $179.46	Professional		$84.35	$109.38	$179.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.08 / $157.43 / $157.43	Professional		$150.08	$157.43	$157.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $337.95 / $578.28 / $1,806.19	Facility		$337.95	$578.28	$1,806.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.29 / $159.53 / $159.53	Professional		$135.29	$159.53	$159.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $229.83	Facility		$140.54	$140.54	$229.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $102.59 / $271.62	Professional		$102.59	$102.59	$271.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $198.16 / $268.00 / $324.27	Professional		$198.16	$268.00	$324.27
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 $272.88 / $272.88 / $272.88	Professional		$272.88	$272.88	$272.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.24 / $118.50 / $177.75	Professional		$107.24	$118.50	$177.75
United Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $104.72 / $183.88	Professional		$77.98	$104.72	$183.88