Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.97 / $1,094.00 / $5,091.00	Facility		$230.97	$1,094.00	$5,091.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.86 / $220.37 / $427.92	Professional		$140.86	$220.37	$427.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.92 / $105.92 / $131.38	Professional		$105.92	$105.92	$131.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.44 / $1,508.01 / $3,289.16	Facility		$858.44	$1,508.01	$3,289.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.73 / $289.39 / $420.96	Professional		$197.73	$289.39	$420.96
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 $166.16 / $264.79 / $428.09	Professional		$166.16	$264.79	$428.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $197.34 / $348.77 / $665.25	Professional		$197.34	$348.77	$665.25
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 $202.23 / $210.03 / $336.60	Professional		$202.23	$210.03	$336.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $380.61	Professional		$32.34	$32.34	$380.61
United Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $1,905.00 / $4,342.00	Facility		$711.00	$1,905.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $222.09 / $308.83 / $549.66	Professional		$222.09	$308.83	$549.66