Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.36 / $1,225.00 / $5,091.00	Facility		$221.36	$1,225.00	$5,091.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $202.59 / $421.29	Professional		$112.20	$202.59	$421.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $246.00 / $268.47	Professional		$156.38	$246.00	$268.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $807.19 / $1,560.95 / $2,431.91	Facility		$807.19	$1,560.95	$2,431.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.85 / $250.93 / $420.74	Professional		$142.85	$250.93	$420.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.53 / $480.00 / $1,231.60	Facility		$205.53	$480.00	$1,231.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.79 / $233.06 / $427.00	Professional		$125.79	$233.06	$427.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.50 / $341.68 / $641.53	Professional		$151.50	$341.68	$641.53
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 $144.16 / $153.57 / $332.40	Professional		$144.16	$153.57	$332.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $375.86	Professional		$32.34	$32.34	$375.86
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 $161.25 / $256.86 / $472.06	Professional		$161.25	$256.86	$472.06