Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $208.93 / $288.40	Professional		$95.50	$208.93	$288.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $741.31	Facility		$602.56	$602.56	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $123.03	Professional		$102.33	$102.33	$123.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $269.15	Professional		$93.33	$128.82	$269.15
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $288.40	Professional		$144.54	$144.54	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $371.54 / $616.60	Facility		$83.18	$371.54	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $416.87 / $645.65	Professional		$316.23	$416.87	$645.65