Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.00 / $599.15 / $1,688.00	Facility		$275.00	$599.15	$1,688.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $155.51 / $263.89 / $360.51	Facility	52	$155.51	$263.89	$360.51
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $233.27 / $395.86 / $540.47	Facility	54	$233.27	$395.86	$540.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.62 / $311.64 / $582.75	Professional		$251.62	$311.64	$582.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $317.56 / $346.55 / $346.55	Professional		$317.56	$346.55	$346.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,334.40 / $7,272.76	Facility		$330.07	$3,334.40	$7,272.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.40 / $520.47 / $697.33	Professional		$376.40	$520.47	$697.33
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 $298.35 / $453.65 / $642.29	Professional		$298.35	$453.65	$642.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $350.19 / $527.66 / $1,751.01	Professional		$350.19	$527.66	$1,751.01
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 $370.14 / $391.98 / $481.59	Professional		$370.14	$391.98	$481.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $544.55	Professional		$32.34	$32.34	$544.55
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 $281.61 / $378.91 / $690.11	Professional		$281.61	$378.91	$690.11