Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $812.83 / $5,623.41	Facility		$194.98	$812.83	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $575.44	Professional		$131.83	$218.78	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $128.82 / $169.82	Professional		$123.03	$128.82	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $354.81 / $2,290.87	Facility		$257.04	$354.81	$2,290.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $269.15	Professional		$158.49	$218.78	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $239.88 / $1,000.00	Facility		$213.80	$239.88	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $218.78 / $398.11	Professional		$141.25	$218.78	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $707.95	Professional		$169.82	$302.00	$707.95
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 $162.18 / $169.82 / $257.04	Professional		$162.18	$169.82	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $691.83 / $2,187.76	Facility		$165.96	$691.83	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $338.84	Professional		$138.04	$204.17	$338.84