Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,230.27 / $5,623.41	Facility		$154.88	$1,230.27	$5,623.41
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $154.88 / $158.49 / $346.74	Facility	54	$154.88	$158.49	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $363.08	Professional		$114.82	$165.96	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $199.53	Professional		$100.00	$141.25	$199.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $426.58 / $2,754.23	Facility		$316.23	$426.58	$2,754.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $288.40	Professional		$151.36	$208.93	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $275.42	Professional		$125.89	$186.21	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $549.54	Professional		$151.36	$229.09	$549.54
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 $154.88 / $158.49 / $199.53	Professional		$154.88	$158.49	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $724.44 / $2,187.76	Facility		$158.49	$724.44	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $263.03	Professional		$117.49	$158.49	$263.03