Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.68 / $686.40 / $5,389.00	Facility		$99.68	$686.40	$5,389.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.46 / $80.97 / $158.86	Facility	52	$31.46	$80.97	$158.86
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.58 / $32.39 / $39.65	Facility	53	$12.58	$32.39	$39.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $123.54 / $244.00	Professional		$62.92	$123.54	$244.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.17 / $49.84 / $99.13	Professional	52	$28.17	$49.84	$99.13
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $11.79 / $19.94 / $39.84	Professional	53	$11.79	$19.94	$39.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.30 / $142.30 / $142.30	Professional		$142.30	$142.30	$142.30
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $35.01 / $35.01 / $35.01	Professional	52	$35.01	$35.01	$35.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.40 / $384.92 / $1,454.25	Facility		$106.40	$384.92	$1,454.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $139.47 / $218.40	Professional		$77.70	$139.47	$218.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $120.73 / $202.70	Professional		$78.66	$120.73	$202.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.23 / $152.43 / $346.55	Professional		$90.23	$152.43	$346.55
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 $72.98 / $80.90 / $137.03	Professional		$72.98	$80.90	$137.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $158.12	Professional		$32.34	$32.34	$158.12
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $900.00 / $3,686.00	Facility		$165.00	$900.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $104.09 / $152.58 / $259.81	Professional		$104.09	$152.58	$259.81