Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.40 / $1,017.00 / $4,634.00	Facility		$124.40	$1,017.00	$4,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.17 / $80.58 / $151.87	Professional		$54.17	$80.58	$151.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.93 / $123.93 / $123.93	Professional		$123.93	$123.93	$123.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $390.79 / $718.69 / $1,567.55	Facility		$390.79	$718.69	$1,567.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.67 / $110.16 / $176.43	Professional		$79.67	$110.16	$176.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.15 / $103.99 / $908.00	Facility		$93.15	$103.99	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $106.69 / $164.03	Professional		$70.70	$106.69	$164.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.99 / $138.68 / $335.03	Professional		$89.99	$138.68	$335.03
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 $77.16 / $83.56 / $121.29	Professional		$77.16	$83.56	$121.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $139.94	Professional		$32.34	$32.34	$139.94
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $107.69 / $184.55	Professional		$78.93	$107.69	$184.55