Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.49 / $57.49 / $57.49	Facility		$57.49	$57.49	$57.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.93 / $57.49 / $89.48	Professional		$44.93	$57.49	$89.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $79.98 / $79.98	Professional		$79.98	$79.98	$79.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.56 / $225.96 / $962.32	Facility		$133.56	$225.96	$962.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $85.01 / $85.01	Professional		$72.09	$85.01	$85.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.72 / $66.72 / $122.47	Facility		$66.72	$66.72	$122.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.71 / $66.72 / $129.75	Professional		$48.71	$66.72	$129.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.46 / $128.63 / $157.55	Professional		$102.46	$128.63	$157.55
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 $145.41 / $145.41 / $145.41	Professional		$145.41	$145.41	$145.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.01 / $84.30 / $88.51	Professional		$59.01	$84.30	$88.51
United Facility/Professional Professional Modifier Low / Median / High Price $41.55 / $55.80 / $98.81	Professional		$41.55	$55.80	$98.81