Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $652.59 / $1,812.85 / $5,393.00	Facility		$652.59	$1,812.85	$5,393.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.78 / $1,015.26 / $2,574.08	Professional		$767.78	$1,015.26	$2,574.08
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $25.02 / $338.72 / $920.60	Professional	AS	$25.02	$338.72	$920.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $976.53 / $976.53 / $976.53	Professional		$976.53	$976.53	$976.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,503.93 / $7,911.98 / $17,257.04	Facility		$4,503.93	$7,911.98	$17,257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,039.89 / $1,277.09 / $1,845.74	Professional		$1,039.89	$1,277.09	$1,845.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $890.45 / $1,253.31 / $1,974.07	Professional		$890.45	$1,253.31	$1,974.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $963.61 / $1,597.17 / $3,663.49	Professional		$963.61	$1,597.17	$3,663.49
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 $1,025.01 / $1,094.11 / $1,482.21	Professional		$1,025.01	$1,094.11	$1,482.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,710.24	Professional		$32.34	$32.34	$1,710.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $5,272.00 / $9,441.00	Facility		$1,600.00	$5,272.00	$9,441.00
United Facility/Professional Professional Modifier Low / Median / High Price $960.90 / $1,354.88 / $2,346.41	Professional		$960.90	$1,354.88	$2,346.41