Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.27 / $1,312.67 / $3,270.00	Facility		$212.27	$1,312.67	$3,270.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $49.51 / $86.81	Facility	53	$19.14	$49.51	$86.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $212.27 / $498.42	Professional		$91.34	$212.27	$498.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.46 / $116.25 / $344.54	Professional		$86.46	$116.25	$344.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $827.72 / $1,162.25 / $2,184.89	Facility		$827.72	$1,162.25	$2,184.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $253.27 / $445.19	Professional		$119.20	$253.27	$445.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $723.35 / $807.53 / $908.00	Facility		$723.35	$807.53	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.27 / $225.63 / $449.28	Professional		$111.27	$225.63	$449.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.81 / $360.82 / $804.39	Professional		$138.81	$360.82	$804.39
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 $118.30 / $123.92 / $334.13	Professional		$118.30	$123.92	$334.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $377.82	Professional		$32.34	$32.34	$377.82
United Facility/Professional Facility Modifier Low / Median / High Price $807.00 / $1,753.00 / $4,256.00	Facility		$807.00	$1,753.00	$4,256.00
United Facility/Professional Professional Modifier Low / Median / High Price $231.16 / $338.39 / $534.59	Professional		$231.16	$338.39	$534.59