Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $141.25	Facility		$67.61	$67.61	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $141.25	Professional		$57.54	$72.44	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $104.71 / $123.03	Professional		$91.20	$104.71	$123.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $269.15 / $954.99	Facility		$165.96	$269.15	$954.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $138.04	Facility		$89.13	$89.13	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $138.04	Professional		$64.57	$64.57	$138.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $194.98	Professional		$120.23	$154.88	$194.98
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 $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
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 $81.28 / $109.65 / $199.53	Facility		$81.28	$109.65	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $102.33	Professional		$52.48	$69.18	$102.33