Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $1,621.81 / $7,762.47	Facility		$309.03	$1,621.81	$7,762.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $489.78	Professional		$158.49	$257.04	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $4,168.69 / $5,623.41	Facility		$676.08	$4,168.69	$5,623.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $416.87	Professional		$186.21	$275.42	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $446.68	Professional		$177.83	$281.84	$446.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $346.74 / $794.33	Professional		$177.83	$346.74	$794.33
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 $199.53 / $199.53 / $331.13	Professional		$199.53	$199.53	$331.13
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 $891.25 / $2,691.53 / $5,128.61	Facility		$891.25	$2,691.53	$5,128.61
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $478.63	Professional		$177.83	$275.42	$478.63