Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $151.36	Facility		$75.86	$75.86	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $151.36	Professional		$61.66	$75.86	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $114.82	Professional		$74.13	$102.33	$114.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $645.65 / $1,513.56	Facility		$204.17	$645.65	$1,513.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $165.96	Facility		$83.18	$83.18	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $162.18	Professional		$61.66	$61.66	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $213.80	Professional		$141.25	$177.83	$213.80
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 $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $112.20	Professional		$77.62	$77.62	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $117.49 / $213.80	Facility		$56.23	$117.49	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $114.82	Professional		$54.95	$74.13	$114.82