Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.50 / $725.00 / $1,080.03	Facility		$262.50	$725.00	$1,080.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $646.00	Professional		$416.78	$416.78	$646.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.00 / $19.00	Professional		$19.00	$19.00	$19.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Facility		$416.78	$416.78	$416.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $354.26 / $416.78	Professional		$3.50	$354.26	$416.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $546.21 / $996.95 / $1,917.92	Facility		$546.21	$996.95	$1,917.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $507.69 / $608.27	Professional		$416.78	$507.69	$608.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $583.49 / $875.24	Professional		$416.78	$583.49	$875.24
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 $541.80 / $541.80 / $541.80	Professional		$541.80	$541.80	$541.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $566.82 / $566.82 / $625.16	Professional		$566.82	$566.82	$625.16
United Facility/Professional Professional Modifier Low / Median / High Price $181.90 / $247.44 / $433.09	Professional		$181.90	$247.44	$433.09