Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.38 / $1,017.00 / $4,634.00	Facility		$137.38	$1,017.00	$4,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $193.73 / $343.21	Professional		$71.14	$193.73	$343.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $103.05 / $103.05	Professional		$103.05	$103.05	$103.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $479.27 / $1,143.50 / $1,637.08	Facility		$479.27	$1,143.50	$1,637.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.28 / $214.57 / $341.79	Professional		$83.28	$214.57	$341.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.40 / $480.00 / $1,000.00	Facility		$122.40	$480.00	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $217.69 / $408.57	Professional		$86.94	$217.69	$408.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.54 / $300.07 / $901.87	Professional		$101.54	$300.07	$901.87
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 $85.28 / $90.82 / $283.35	Professional		$85.28	$90.82	$283.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $320.39	Professional		$32.34	$32.34	$320.39
United Facility/Professional Facility Modifier Low / Median / High Price $815.00 / $2,588.00 / $4,780.00	Facility		$815.00	$2,588.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $205.74 / $304.70 / $495.80	Professional		$205.74	$304.70	$495.80