Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $1,288.25 / $5,623.41	Facility		$263.03	$1,288.25	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $426.58	Professional		$144.54	$218.78	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $302.00	Professional		$91.20	$134.90	$302.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $1,737.80 / $2,511.89	Facility		$371.54	$1,737.80	$2,511.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $295.12	Professional		$173.78	$245.47	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $302.00 / $831.76	Facility		$269.15	$302.00	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $251.19 / $426.58	Professional		$158.49	$251.19	$426.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $380.19 / $1,000.00	Professional		$194.98	$380.19	$1,000.00
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 $186.21 / $190.55 / $295.12	Professional		$186.21	$190.55	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $323.59	Professional		$32.36	$33.11	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,445.44 / $3,890.45	Facility		$660.69	$1,445.44	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $223.87 / $380.19	Professional		$154.88	$223.87	$380.19