Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $816.26 / $4,330.00 / $10,854.12	Facility		$816.26	$4,330.00	$10,854.12
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,483.00 / $5,483.00 / $5,483.00	Facility	50	$5,483.00	$5,483.00	$5,483.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.34 / $772.99 / $2,378.59	Professional		$517.34	$772.99	$2,378.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $719.34 / $719.34 / $719.34	Professional		$719.34	$719.34	$719.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,889.58 / $6,642.72 / $14,488.63	Facility		$3,889.58	$6,642.72	$14,488.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $688.45 / $1,015.24 / $1,093.18	Professional		$688.45	$1,015.24	$1,093.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $3,430.33 / $10,111.00	Facility		$875.00	$3,430.33	$10,111.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $584.22 / $829.75 / $1,276.31	Professional		$584.22	$829.75	$1,276.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $663.01 / $966.89 / $4,170.93	Professional		$663.01	$966.89	$4,170.93
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 $669.25 / $718.26 / $799.02	Professional		$669.25	$718.26	$799.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $903.51	Professional		$32.34	$32.34	$903.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $4,530.00 / $8,995.00	Facility		$1,600.00	$4,530.00	$8,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $546.64 / $787.13 / $1,243.47	Professional		$546.64	$787.13	$1,243.47