Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $9,549.93 / $28,183.83	Facility		$2,187.76	$9,549.93	$28,183.83
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	22	$1,949.84	$1,949.84	$1,949.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,317.64 / $20,417.38 / $23,442.29	Facility	50	$8,317.64	$20,417.38	$23,442.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,905.46 / $5,754.40	Professional		$501.19	$1,905.46	$5,754.40
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $346.74 / $977.24	Professional	AS	$169.82	$346.74	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $1,122.02 / $1,698.24	Professional		$158.49	$1,122.02	$1,698.24
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $138.04 / $302.00 / $354.81	Professional	AS	$138.04	$302.00	$354.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $14,454.40 / $18,620.87 / $29,512.09	Facility		$14,454.40	$18,620.87	$29,512.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,187.76 / $2,630.27	Professional		$1,584.89	$2,187.76	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $14,791.08 / $18,197.01	Facility		$5,248.07	$14,791.08	$18,197.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $3,019.95	Professional		$1,288.25	$1,905.46	$3,019.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,187.76 / $8,709.64	Professional		$1,380.38	$2,187.76	$8,709.64
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 $1,479.11 / $1,659.59 / $1,819.70	Professional		$1,479.11	$1,659.59	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,348.96	Professional		$32.36	$33.11	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $10,000.00 / $25,703.96	Facility		$2,570.40	$10,000.00	$25,703.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,778.28 / $2,951.21	Professional		$1,258.93	$1,778.28	$2,951.21