Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $1,096.48 / $5,623.41	Facility		$134.90	$1,096.48	$5,623.41
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $154.88 / $158.49 / $467.74	Facility	54	$154.88	$158.49	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $331.13	Professional		$104.71	$165.96	$331.13
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $74.13 / $199.53 / $478.63	Professional	54	$74.13	$199.53	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $181.97	Professional		$107.15	$125.89	$181.97
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $38.02 / $77.62 / $117.49	Professional	54	$38.02	$77.62	$117.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $426.58 / $2,630.27	Facility		$316.23	$426.58	$2,630.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $245.47	Professional		$144.54	$199.53	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $251.19	Professional		$112.20	$158.49	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $478.63	Professional		$138.04	$204.17	$478.63
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 $151.36 / $151.36 / $169.82	Professional		$151.36	$151.36	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $141.25	Professional		$32.36	$32.36	$141.25
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 $107.15 / $141.25 / $245.47	Professional		$107.15	$141.25	$245.47