Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $776.25 / $5,248.07	Facility		$97.72	$776.25	$5,248.07
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,659.59 / $2,137.96 / $2,290.87	Facility	50	$1,659.59	$2,137.96	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $112.20 / $331.13	Professional		$57.54	$112.20	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $346.74 / $380.19	Professional	50	$141.25	$346.74	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $89.13	Professional		$53.70	$61.66	$89.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,023.29 / $1,380.38	Facility		$630.96	$1,023.29	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $208.93	Professional		$77.62	$123.03	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $114.82 / $199.53	Professional		$66.07	$114.82	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $186.21 / $891.25	Professional		$91.20	$186.21	$891.25
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 / $154.88	Professional		$75.86	$81.28	$154.88
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 $575.44 / $1,479.11 / $3,715.35	Facility		$575.44	$1,479.11	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $181.97	Professional		$58.88	$97.72	$181.97