Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.25 / $1,192.00 / $4,500.00	Facility		$100.25	$1,192.00	$4,500.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,213.02 / $1,301.25 / $9,681.28	Facility	50	$1,213.02	$1,301.25	$9,681.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.43 / $83.28 / $168.94	Professional		$48.43	$83.28	$168.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.45 / $201.03 / $676.13	Professional	50	$79.45	$201.03	$676.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $110.81 / $111.61	Professional		$79.52	$110.81	$111.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $519.59 / $943.87 / $1,297.30	Facility		$519.59	$943.87	$1,297.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $100.32 / $177.31	Professional		$59.64	$100.32	$177.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.81 / $110.31 / $908.00	Facility		$98.81	$110.31	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.17 / $93.78 / $163.02	Professional		$58.17	$93.78	$163.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $138.22 / $345.40	Professional		$73.72	$138.22	$345.40
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 $61.17 / $66.09 / $120.91	Professional		$61.17	$66.09	$120.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $139.52	Professional		$32.34	$32.34	$139.52
United Facility/Professional Facility Modifier Low / Median / High Price $807.00 / $1,753.00 / $4,256.00	Facility		$807.00	$1,753.00	$4,256.00
United Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $108.96 / $176.24	Professional		$77.95	$108.96	$176.24