Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.40 / $1,055.00 / $5,091.00	Facility		$223.40	$1,055.00	$5,091.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.98 / $207.68 / $418.69	Professional		$114.98	$207.68	$418.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.13 / $150.05 / $332.10	Professional		$125.13	$150.05	$332.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.75 / $1,437.12 / $3,134.54	Facility		$549.75	$1,437.12	$3,134.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $275.70 / $406.75	Professional		$188.20	$275.70	$406.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $463.00 / $480.00	Facility		$463.00	$463.00	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.84 / $252.03 / $406.82	Professional		$160.84	$252.03	$406.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.33 / $337.78 / $684.98	Professional		$186.33	$337.78	$684.98
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 $193.51 / $200.10 / $325.12	Professional		$193.51	$200.10	$325.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $367.63	Professional		$32.34	$32.34	$367.63
United Facility/Professional Facility Modifier Low / Median / High Price $204.00 / $814.00 / $3,685.00	Facility		$204.00	$814.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $217.60 / $306.66 / $530.79	Professional		$217.60	$306.66	$530.79