Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.95 / $74.95 / $74.95	Facility		$74.95	$74.95	$74.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.01 / $74.95 / $124.25	Professional		$66.01	$74.95	$124.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.47 / $204.47 / $204.47	Professional		$204.47	$204.47	$204.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.40 / $306.66 / $1,659.20	Facility		$182.40	$306.66	$1,659.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.11 / $151.46 / $151.46	Professional		$115.11	$151.46	$151.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.15 / $98.15 / $165.74	Facility		$98.15	$98.15	$165.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $98.15 / $175.50	Professional		$71.65	$98.15	$175.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.98 / $151.46 / $189.94	Professional		$122.98	$151.46	$189.94
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 $196.90 / $196.90 / $196.90	Professional		$196.90	$196.90	$196.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.07 / $91.54 / $96.11	Professional		$64.07	$91.54	$96.11
United Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $75.56 / $157.41	Professional		$57.66	$75.56	$157.41