Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.28 / $1,017.00 / $4,634.00	Facility		$210.28	$1,017.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $143.13 / $260.82 / $311.13	Facility	54	$143.13	$260.82	$311.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $200.16 / $377.90	Professional		$164.59	$200.16	$377.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $194.10 / $194.10	Professional		$194.10	$194.10	$194.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,046.09 / $4,462.79	Facility		$330.07	$2,046.09	$4,462.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.31 / $319.83 / $430.99	Professional		$231.31	$319.83	$430.99
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 $202.31 / $299.24 / $431.34	Professional		$202.31	$299.24	$431.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $237.48 / $344.35 / $754.44	Professional		$237.48	$344.35	$754.44
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 $237.76 / $243.14 / $295.13	Professional		$237.76	$243.14	$295.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $339.48	Professional		$32.34	$32.34	$339.48
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 $198.98 / $264.48 / $457.81	Professional		$198.98	$264.48	$457.81