Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $314.45 / $931.53 / $4,634.00	Facility		$314.45	$931.53	$4,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.05 / $442.54 / $906.38	Professional		$170.05	$442.54	$906.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $176.14 / $264.20 / $470.11	Professional		$176.14	$264.20	$470.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,193.32 / $3,063.45 / $4,659.71	Facility		$1,193.32	$3,063.45	$4,659.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.52 / $519.96 / $903.29	Professional		$213.52	$519.96	$903.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $480.00 / $2,720.17	Facility		$300.00	$480.00	$2,720.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.03 / $395.41 / $981.21	Professional		$204.03	$395.41	$981.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $249.13 / $729.84 / $1,591.88	Professional		$249.13	$729.84	$1,591.88
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 $216.71 / $231.34 / $728.90	Professional		$216.71	$231.34	$728.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $824.21	Professional		$32.34	$32.34	$824.21
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 $490.89 / $668.85 / $1,155.47	Professional		$490.89	$668.85	$1,155.47