Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.21 / $1,561.84 / $5,483.00	Facility		$145.21	$1,561.84	$5,483.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $145.21 / $302.61	Professional		$67.98	$145.21	$302.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.27 / $149.27 / $149.27	Professional		$149.27	$149.27	$149.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $685.54 / $1,572.52 / $4,863.03	Facility		$685.54	$1,572.52	$4,863.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $179.62 / $326.75	Professional		$86.14	$179.62	$326.75
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 $92.73 / $178.00 / $313.07	Professional		$92.73	$178.00	$313.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.82 / $245.35 / $536.23	Professional		$103.82	$245.35	$536.23
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 $88.52 / $93.03 / $229.45	Professional		$88.52	$93.03	$229.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $264.75	Professional		$32.34	$32.34	$264.75
United Facility/Professional Facility Modifier Low / Median / High Price $749.00 / $2,588.00 / $5,026.00	Facility		$749.00	$2,588.00	$5,026.00
United Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $250.70 / $430.39	Professional		$169.40	$250.70	$430.39