Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.31 / $755.00 / $5,389.00	Facility		$120.31	$755.00	$5,389.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.47 / $36.88 / $67.91	Facility	53	$16.47	$36.88	$67.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $160.54 / $308.68	Professional		$76.23	$160.54	$308.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.56 / $78.56 / $112.60	Professional		$78.56	$78.56	$112.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $490.65 / $1,049.52 / $2,101.66	Facility		$490.65	$1,049.52	$2,101.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $196.00 / $323.32	Professional		$99.80	$196.00	$323.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.04 / $181.68 / $338.86	Professional		$91.04	$181.68	$338.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.22 / $278.95 / $683.98	Professional		$116.22	$278.95	$683.98
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 $97.97 / $103.58 / $242.26	Professional		$97.97	$103.58	$242.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $273.93	Professional		$32.34	$32.34	$273.93
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 $204.27 / $290.39 / $421.65	Professional		$204.27	$290.39	$421.65