Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.53 / $603.45 / $3,270.00	Facility		$189.53	$603.45	$3,270.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $153.41 / $277.89 / $333.95	Facility	54	$153.41	$277.89	$333.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $217.28 / $426.25	Professional		$175.61	$217.28	$426.25
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $135.19 / $157.82 / $298.33	Professional	54	$135.19	$157.82	$298.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.48 / $199.48 / $213.45	Professional		$199.48	$199.48	$213.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,192.92 / $4,783.06	Facility		$330.07	$2,192.92	$4,783.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.25 / $341.88 / $442.75	Professional		$247.25	$341.88	$442.75
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 $209.20 / $300.68 / $438.92	Professional		$209.20	$300.68	$438.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $243.91 / $348.02 / $754.84	Professional		$243.91	$348.02	$754.84
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 $255.06 / $259.62 / $303.30	Professional		$255.06	$259.62	$303.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $349.14	Professional		$32.34	$32.34	$349.14
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $831.00 / $3,399.00	Facility		$165.00	$831.00	$3,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $199.78 / $275.55 / $473.81	Professional		$199.78	$275.55	$473.81