Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $630.96 / $5,248.07	Facility		$154.88	$630.96	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $251.19	Professional		$151.36	$151.36	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $128.82	Professional		$114.82	$128.82	$128.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $213.80 / $346.74	Facility		$177.83	$213.80	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $177.83	Professional		$151.36	$151.36	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $380.19	Professional		$134.90	$199.53	$380.19
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 $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $263.03 / $263.03	Facility		$158.49	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $331.13	Professional		$125.89	$158.49	$331.13