Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $718.61 / $1,842.00 / $5,405.00	Facility		$718.61	$1,842.00	$5,405.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $573.00 / $718.61 / $1,304.49	Professional		$573.00	$718.61	$1,304.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $818.08 / $818.08 / $818.08	Professional		$818.08	$818.08	$818.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,517.01 / $5,817.93 / $12,689.64	Facility		$2,517.01	$5,817.93	$12,689.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $763.61 / $1,025.02 / $1,328.72	Professional		$763.61	$1,025.02	$1,328.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $709.00 / $709.00 / $735.00	Facility		$709.00	$709.00	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.75 / $903.64 / $1,428.66	Professional		$647.75	$903.64	$1,428.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $733.28 / $1,140.65 / $2,564.62	Professional		$733.28	$1,140.65	$2,564.62
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 $776.62 / $810.16 / $1,059.18	Professional		$776.62	$810.16	$1,059.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,222.13	Professional		$32.34	$32.34	$1,222.13
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 $702.86 / $1,002.09 / $1,742.03	Professional		$702.86	$1,002.09	$1,742.03