Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.87 / $122.87 / $239.05	Facility		$122.87	$122.87	$239.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $128.25 / $340.00	Professional		$109.42	$128.25	$340.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.29 / $179.29 / $179.29	Professional		$179.29	$179.29	$179.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $384.87 / $656.36 / $2,056.84	Facility		$384.87	$656.36	$2,056.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.08 / $181.68 / $181.68	Professional		$154.08	$181.68	$181.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.55 / $152.55 / $261.67	Facility		$152.55	$152.55	$261.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $152.55 / $277.13	Professional		$111.36	$152.55	$277.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.48 / $249.53 / $349.15	Professional		$199.48	$249.53	$349.15
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 $310.77 / $310.77 / $310.77	Professional		$310.77	$310.77	$310.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $155.86 / $222.67 / $233.80	Professional		$155.86	$222.67	$233.80
United Facility/Professional Professional Modifier Low / Median / High Price $88.78 / $119.26 / $211.17	Professional		$88.78	$119.26	$211.17