Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $412.22 / $1,169.00 / $4,634.00	Facility		$412.22	$1,169.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $180.71 / $318.60 / $384.11	Facility	54	$180.71	$318.60	$384.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.02 / $240.94 / $425.46	Professional		$200.02	$240.94	$425.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.20 / $226.20 / $226.20	Professional		$226.20	$226.20	$226.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,661.63 / $5,805.36	Facility		$330.07	$2,661.63	$5,805.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.54 / $405.90 / $509.00	Professional		$293.54	$405.90	$509.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $280.07 / $480.00	Facility		$250.87	$280.07	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.51 / $352.22 / $498.67	Professional		$225.51	$352.22	$498.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $266.73 / $394.48 / $812.74	Professional		$266.73	$394.48	$812.74
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 $302.85 / $305.25 / $340.69	Professional		$302.85	$305.25	$340.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $385.24	Professional		$32.34	$32.34	$385.24
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 $217.30 / $294.07 / $506.74	Professional		$217.30	$294.07	$506.74