Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.54 / $76.54 / $154.65	Facility		$76.54	$76.54	$154.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $76.54 / $126.86	Professional		$67.40	$76.54	$126.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.56 / $115.99 / $115.99	Professional		$110.56	$115.99	$115.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.44 / $312.04 / $1,330.61	Facility		$184.44	$312.04	$1,330.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.53 / $117.53 / $132.32	Professional		$117.53	$117.53	$132.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $100.03 / $169.28	Facility		$100.03	$100.03	$169.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $100.03 / $179.25	Professional		$73.02	$100.03	$179.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $153.88 / $188.91 / $229.22	Professional		$153.88	$188.91	$229.22
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 $201.05 / $201.05 / $201.05	Professional		$201.05	$201.05	$201.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $116.57 / $122.39	Professional		$81.59	$116.57	$122.39
United Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $77.15 / $136.62	Professional		$57.43	$77.15	$136.62