Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.17 / $1,305.00 / $5,389.00	Facility		$207.17	$1,305.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.29 / $173.48 / $310.08	Professional		$105.29	$173.48	$310.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.07 / $217.07 / $217.07	Professional		$217.07	$217.07	$217.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $454.88 / $1,844.04 / $5,442.83	Facility		$454.88	$1,844.04	$5,442.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.79 / $189.93 / $309.68	Professional		$126.79	$189.93	$309.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.01 / $400.00 / $1,300.00	Facility		$186.01	$400.00	$1,300.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.68 / $192.24 / $342.12	Professional		$121.68	$192.24	$342.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.04 / $265.51 / $557.63	Professional		$148.04	$265.51	$557.63
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 $132.72 / $137.46 / $247.87	Professional		$132.72	$137.46	$247.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $280.27	Professional		$32.34	$32.34	$280.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $2,435.00 / $4,749.00	Facility		$1,183.00	$2,435.00	$4,749.00
United Facility/Professional Professional Modifier Low / Median / High Price $165.67 / $225.95 / $384.77	Professional		$165.67	$225.95	$384.77