Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,047.13 / $5,623.41	Facility		$239.88	$1,047.13	$5,623.41
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	54	$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $407.38	Professional		$131.83	$181.97	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $426.58 / $3,090.30	Facility		$316.23	$426.58	$3,090.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $331.13	Professional		$169.82	$234.42	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $208.93 / $309.03	Professional		$144.54	$208.93	$309.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $537.03	Professional		$173.78	$263.03	$537.03
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 $177.83 / $181.97 / $223.87	Professional		$177.83	$181.97	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
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 $134.90 / $181.97 / $302.00	Professional		$134.90	$181.97	$302.00