Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.85 / $1,630.00 / $6,790.79	Facility		$217.85	$1,630.00	$6,790.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.22 / $209.34 / $394.85	Professional		$148.22	$209.34	$394.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.94 / $145.80 / $168.43	Professional		$114.94	$145.80	$168.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,514.18 / $2,280.10 / $3,522.45	Facility		$1,514.18	$2,280.10	$3,522.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.59 / $279.49 / $403.70	Professional		$217.59	$279.49	$403.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.00 / $620.00 / $643.00	Facility		$620.00	$620.00	$643.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.80 / $266.86 / $416.70	Professional		$176.80	$266.86	$416.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $205.62 / $344.83 / $656.06	Professional		$205.62	$344.83	$656.06
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 $216.76 / $228.94 / $324.38	Professional		$216.76	$228.94	$324.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $366.79	Professional		$32.34	$32.34	$366.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $2,622.00 / $5,026.00	Facility		$1,183.00	$2,622.00	$5,026.00
United Facility/Professional Professional Modifier Low / Median / High Price $208.31 / $290.58 / $492.20	Professional		$208.31	$290.58	$492.20