Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.77 / $1,365.00 / $6,108.33	Facility		$253.77	$1,365.00	$6,108.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.84 / $253.77 / $527.24	Professional		$130.84	$253.77	$527.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $143.53 / $179.50	Professional		$72.88	$143.53	$179.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $919.33 / $2,620.78 / $4,602.53	Facility		$919.33	$2,620.78	$4,602.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $295.20 / $497.13	Professional		$163.19	$295.20	$497.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.97 / $480.00 / $2,720.17	Facility		$233.97	$480.00	$2,720.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $276.13 / $532.61	Professional		$152.91	$276.13	$532.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $187.04 / $414.23 / $875.44	Professional		$187.04	$414.23	$875.44
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 $162.99 / $175.24 / $413.84	Professional		$162.99	$175.24	$413.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $467.96	Professional		$32.34	$32.34	$467.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,098.00 / $3,975.00 / $6,625.00	Facility		$1,098.00	$3,975.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $256.62 / $354.89 / $643.53	Professional		$256.62	$354.89	$643.53