Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,258.93 / $5,623.41	Facility		$131.83	$1,258.93	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $128.82 / $331.13	Professional		$60.26	$128.82	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $134.90 / $208.93	Professional	50	$134.90	$134.90	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $74.13	Professional		$53.70	$61.66	$74.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,288.25 / $1,548.82	Facility		$645.65	$1,288.25	$1,548.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $281.84	Professional		$77.62	$158.49	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $131.83 / $263.03	Professional		$69.18	$131.83	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $239.88 / $851.14	Professional		$93.33	$239.88	$851.14
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 $75.86 / $81.28 / $208.93	Professional		$75.86	$81.28	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,479.11 / $3,715.35	Facility		$724.44	$1,479.11	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $125.89 / $239.88	Professional		$66.07	$125.89	$239.88