Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.84 / $813.00 / $5,405.00	Facility		$105.84	$813.00	$5,405.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $97.02 / $204.72	Professional		$47.82	$97.02	$204.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.86 / $113.86 / $113.86	Professional		$113.86	$113.86	$113.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.91 / $385.26 / $1,016.14	Facility		$258.91	$385.26	$1,016.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $119.59 / $191.24	Professional		$60.90	$119.59	$191.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $101.19 / $189.82	Professional		$58.94	$101.19	$189.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.18 / $153.27 / $270.02	Professional		$70.18	$153.27	$270.02
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 $61.79 / $65.17 / $153.27	Professional		$61.79	$65.17	$153.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $173.31	Professional		$32.34	$32.34	$173.31
United Facility/Professional Facility Modifier Low / Median / High Price $204.00 / $916.00 / $3,606.00	Facility		$204.00	$916.00	$3,606.00
United Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $130.26 / $229.73	Professional		$94.74	$130.26	$229.73