Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $317.19 / $585.00 / $3,073.00	Facility		$317.19	$585.00	$3,073.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $248.52 / $421.48 / $530.07	Facility	54	$248.52	$421.48	$530.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.37 / $346.60 / $704.16	Professional		$247.37	$346.60	$704.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $614.82 / $1,138.73 / $1,219.97	Professional	50	$614.82	$1,138.73	$1,219.97
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $209.94 / $253.46 / $465.98	Professional	54	$209.94	$253.46	$465.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $351.77 / $367.84 / $428.18	Professional		$351.77	$367.84	$428.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,776.61 / $6,056.14	Facility		$330.07	$2,776.61	$6,056.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $385.90 / $423.28 / $700.74	Professional		$385.90	$423.28	$700.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $250.87 / $280.07	Facility		$250.87	$250.87	$280.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.12 / $482.98 / $679.75	Professional		$279.12	$482.98	$679.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $350.51 / $548.29 / $1,370.49	Professional		$350.51	$548.29	$1,370.49
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 $406.51 / $417.09 / $484.03	Professional		$406.51	$417.09	$484.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $547.33	Professional		$32.34	$32.34	$547.33
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 $291.01 / $400.79 / $705.82	Professional		$291.01	$400.79	$705.82