Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $250.30 / $1,305.00 / $4,809.68	Facility		$250.30	$1,305.00	$4,809.68
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $82.43 / $208.10 / $450.95	Facility	52	$82.43	$208.10	$450.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.53 / $298.39 / $980.97	Professional		$138.53	$298.39	$980.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.11 / $149.11 / $149.11	Professional		$149.11	$149.11	$149.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $899.32 / $2,137.52 / $3,445.79	Facility		$899.32	$2,137.52	$3,445.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.68 / $615.76 / $1,117.10	Professional		$172.68	$615.76	$1,117.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.55 / $397.79 / $1,328.24	Professional		$175.55	$397.79	$1,328.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $206.09 / $865.98 / $1,506.30	Professional		$206.09	$865.98	$1,506.30
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 $174.27 / $185.24 / $832.53	Professional		$174.27	$185.24	$832.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $960.62	Professional		$32.34	$32.34	$960.62
United Facility/Professional Facility Modifier Low / Median / High Price $553.00 / $1,763.00 / $4,342.00	Facility		$553.00	$1,763.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $618.47 / $1,076.73 / $1,619.91	Professional		$618.47	$1,076.73	$1,619.91