Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $785.84 / $6,500.00 / $15,180.80	Facility		$785.84	$6,500.00	$15,180.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,566.06 / $5,597.44 / $15,817.59	Facility	50	$3,566.06	$5,597.44	$15,817.59
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $253.34 / $253.34 / $253.34	Facility	AS	$253.34	$253.34	$253.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.11 / $652.42 / $2,334.10	Professional		$296.11	$652.42	$2,334.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $398.99 / $638.38 / $798.82	Professional		$398.99	$638.38	$798.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,889.58 / $6,290.98 / $13,414.74	Facility		$3,889.58	$6,290.98	$13,414.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $644.29 / $936.25 / $1,052.56	Professional		$644.29	$936.25	$1,052.56
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 $562.87 / $798.83 / $1,225.75	Professional		$562.87	$798.83	$1,225.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $637.91 / $930.97 / $3,348.63	Professional		$637.91	$930.97	$3,348.63
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 $645.75 / $691.57 / $769.24	Professional		$645.75	$691.57	$769.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $869.83	Professional		$32.34	$32.34	$869.83
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 $517.96 / $714.01 / $1,197.31	Professional		$517.96	$714.01	$1,197.31