Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,412.54 / $5,623.41	Facility		$223.87	$1,412.54	$5,623.41
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	52	$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $204.17 / $602.56	Professional		$81.28	$204.17	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $112.20	Professional		$66.07	$85.11	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,023.29 / $1,778.28	Facility		$870.96	$1,023.29	$1,778.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $218.78 / $331.13	Professional		$102.33	$218.78	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $436.52	Professional		$97.72	$208.93	$436.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $338.84 / $691.83	Professional		$114.82	$338.84	$691.83
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 $100.00 / $107.15 / $288.40	Professional		$100.00	$107.15	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,479.11 / $3,801.89	Facility		$575.44	$1,479.11	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $234.42 / $457.09	Professional		$97.72	$234.42	$457.09