Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.27 / $1,094.00 / $4,634.00	Facility		$176.27	$1,094.00	$4,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $152.49 / $475.32	Professional		$92.35	$152.49	$475.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.58 / $126.58 / $207.24	Professional		$126.58	$126.58	$207.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.36 / $801.53 / $1,864.61	Facility		$478.36	$801.53	$1,864.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $166.27 / $236.56	Professional		$107.92	$166.27	$236.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.83 / $587.00 / $908.00	Facility		$158.83	$587.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.23 / $171.30 / $285.32	Professional		$104.23	$171.30	$285.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.57 / $215.93 / $497.24	Professional		$125.57	$215.93	$497.24
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 $110.45 / $117.83 / $199.56	Professional		$110.45	$117.83	$199.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $225.66	Professional		$32.34	$32.34	$225.66
United Facility/Professional Facility Modifier Low / Median / High Price $204.00 / $891.00 / $3,399.00	Facility		$204.00	$891.00	$3,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.43 / $194.73 / $344.24	Professional		$140.43	$194.73	$344.24