Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $75.86	Facility		$36.31	$36.31	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $75.86	Professional		$31.62	$41.69	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $141.25 / $512.86	Facility		$87.10	$141.25	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $95.50	Facility		$45.71	$45.71	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $85.11	Professional		$33.11	$33.11	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $117.49	Professional		$67.61	$91.20	$117.49
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 $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $56.23	Professional		$38.90	$38.90	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $58.88 / $120.23	Facility		$48.98	$58.88	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $61.66	Professional		$30.20	$37.15	$61.66