Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.12 / $1,019.00 / $4,634.00	Facility		$135.12	$1,019.00	$4,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $149.93 / $294.20	Professional		$78.98	$149.93	$294.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $102.38 / $115.18	Professional		$102.38	$102.38	$115.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.38 / $1,402.59 / $2,719.24	Facility		$537.38	$1,402.59	$2,719.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.56 / $181.64 / $291.07	Professional		$95.56	$181.64	$291.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.38 / $480.00 / $1,378.17	Facility		$140.38	$480.00	$1,378.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $177.27 / $345.95	Professional		$95.11	$177.27	$345.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $246.37 / $691.10	Professional		$115.18	$246.37	$691.10
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 $96.85 / $103.32 / $228.77	Professional		$96.85	$103.32	$228.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $258.69	Professional		$32.34	$32.34	$258.69
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 $166.20 / $225.48 / $415.46	Professional		$166.20	$225.48	$415.46