Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.78 / $1,055.00 / $3,636.00	Facility		$121.78	$1,055.00	$3,636.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $635.91 / $2,228.37 / $4,172.50	Facility	50	$635.91	$2,228.37	$4,172.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.19 / $93.67 / $187.87	Professional		$55.19	$93.67	$187.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.74 / $91.74 / $982.35	Professional	50	$91.74	$91.74	$982.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.52 / $53.52 / $53.52	Professional		$53.52	$53.52	$53.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $554.58 / $952.90 / $1,342.73	Facility		$554.58	$952.90	$1,342.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $108.65 / $175.79	Professional		$71.34	$108.65	$175.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $723.35 / $807.53	Facility		$463.00	$723.35	$807.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.11 / $115.93 / $203.79	Professional		$67.11	$115.93	$203.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $151.66 / $553.66	Professional		$80.73	$151.66	$553.66
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 $69.62 / $73.84 / $131.19	Professional		$69.62	$73.84	$131.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $148.35	Professional		$32.34	$32.34	$148.35
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 $96.96 / $168.21 / $251.43	Professional		$96.96	$168.21	$251.43