Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.67 / $192.00 / $200.94	Facility		$62.67	$192.00	$200.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.14 / $153.37 / $254.73	Professional		$110.14	$153.37	$254.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.38 / $191.93 / $206.76	Professional		$101.38	$191.93	$206.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $361.93 / $1,320.24 / $2,879.61	Facility		$361.93	$1,320.24	$2,879.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.08 / $208.38 / $208.38	Professional		$182.08	$208.38	$208.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $300.07	Facility		$142.00	$142.00	$300.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $142.00 / $318.00	Professional		$103.66	$142.00	$318.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $234.32 / $286.23 / $392.66	Professional		$234.32	$286.23	$392.66
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 $356.45 / $356.45 / $356.45	Professional		$356.45	$356.45	$356.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.03 / $110.05 / $115.55	Professional		$77.03	$110.05	$115.55
United Facility/Professional Professional Modifier Low / Median / High Price $104.39 / $136.78 / $240.17	Professional		$104.39	$136.78	$240.17