Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.84 / $208.84 / $208.84	Facility		$208.84	$208.84	$208.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.48 / $208.84 / $332.53	Professional		$171.48	$208.84	$332.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $569.63 / $569.63 / $569.63	Professional		$569.63	$569.63	$569.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $507.20 / $852.73 / $4,622.64	Facility		$507.20	$852.73	$4,622.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.68 / $421.95 / $421.95	Professional		$320.68	$421.95	$421.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $296.00 / $470.79	Facility		$296.00	$296.00	$470.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.08 / $296.00 / $489.00	Professional		$216.08	$296.00	$489.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $337.56 / $421.95 / $500.47	Professional		$337.56	$421.95	$500.47
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 $548.54 / $548.54 / $548.54	Professional		$548.54	$548.54	$548.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $170.46 / $243.52 / $255.69	Professional		$170.46	$243.52	$255.69
United Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $210.51 / $361.38	Professional		$157.43	$210.51	$361.38