Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $641.89 / $4,184.70 / $9,342.87	Facility		$641.89	$4,184.70	$9,342.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $79.43 / $226.84 / $383.14	Facility	53	$79.43	$226.84	$383.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $332.23 / $671.12 / $1,915.72	Professional		$332.23	$671.12	$1,915.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $341.01 / $461.41 / $599.98	Professional		$341.01	$461.41	$599.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,611.34 / $5,282.44 / $10,005.49	Facility		$2,611.34	$5,282.44	$10,005.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $404.42 / $977.26 / $1,995.61	Professional		$404.42	$977.26	$1,995.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $709.00 / $709.00 / $735.00	Facility		$709.00	$709.00	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.76 / $803.04 / $1,657.58	Professional		$385.76	$803.04	$1,657.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $422.66 / $1,278.71 / $2,918.29	Professional		$422.66	$1,278.71	$2,918.29
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 $382.24 / $416.94 / $1,231.34	Professional		$382.24	$416.94	$1,231.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,392.37	Professional		$32.34	$32.34	$1,392.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,690.00 / $5,000.00 / $8,981.00	Facility		$1,690.00	$5,000.00	$8,981.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,104.70 / $1,612.76 / $2,657.91	Professional		$1,104.70	$1,612.76	$2,657.91