Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,122.02 / $5,623.41	Facility		$234.42	$1,122.02	$5,623.41
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $257.04 / $316.23 / $3,162.28	Facility	50	$257.04	$316.23	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $194.98 / $524.81	Professional		$87.10	$194.98	$524.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $398.11 / $1,148.15	Professional	50	$147.91	$398.11	$1,148.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $234.42	Professional		$151.36	$186.21	$234.42
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $257.04 / $323.59	Professional	50	$165.96	$257.04	$323.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $602.56 / $1,949.84	Facility		$478.63	$602.56	$1,949.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $208.93 / $489.78	Professional		$95.50	$208.93	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $199.53 / $354.81	Professional		$95.50	$199.53	$354.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $275.42 / $630.96	Professional		$112.20	$275.42	$630.96
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 $85.11 / $97.72 / $269.15	Professional		$85.11	$97.72	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $758.58 / $2,187.76	Facility		$158.49	$758.58	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $190.55 / $363.08	Professional		$91.20	$190.55	$363.08