Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.59 / $783.26 / $3,011.48	Facility		$88.59	$783.26	$3,011.48
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $382.78 / $730.37 / $2,405.31	Facility	50	$382.78	$730.37	$2,405.31
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $22.74 / $43.51 / $68.87	Facility	52	$22.74	$43.51	$68.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $75.88 / $224.25	Professional		$44.10	$75.88	$224.25
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $283.56 / $637.50 / $956.25	Professional	22	$283.56	$637.50	$956.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $76.56 / $130.36 / $406.50	Professional	50	$76.56	$130.36	$406.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $67.47 / $92.65	Professional		$41.18	$67.47	$92.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $61.07 / $101.21 / $139.59	Professional	50	$61.07	$101.21	$139.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.61 / $52.61 / $52.61	Facility		$52.61	$52.61	$52.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $74.03 / $134.26	Professional		$52.61	$74.03	$134.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.45 / $73.06 / $480.00	Facility		$65.45	$73.06	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $76.81 / $122.17	Professional		$49.22	$76.81	$122.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.11 / $99.26 / $292.20	Professional		$63.11	$99.26	$292.20
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 $52.74 / $57.64 / $89.22	Professional		$52.74	$57.64	$89.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $102.95	Professional		$32.34	$32.34	$102.95
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 $58.41 / $84.74 / $138.38	Professional		$58.41	$84.74	$138.38
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $85.00	Professional	50	$80.00	$80.00	$85.00