Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.36 / $1,207.00 / $4,224.00	Facility		$219.36	$1,207.00	$4,224.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $583.37 / $800.43 / $2,763.15	Facility	50	$583.37	$800.43	$2,763.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.56 / $230.74 / $420.46	Professional		$114.56	$230.74	$420.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $288.25 / $290.80 / $556.23	Professional	50	$288.25	$290.80	$556.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.64 / $182.64 / $182.64	Professional		$182.64	$182.64	$182.64
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $358.52 / $358.52 / $358.52	Professional	50	$358.52	$358.52	$358.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,064.09 / $1,494.17 / $2,871.15	Facility		$1,064.09	$1,494.17	$2,871.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.84 / $282.11 / $465.38	Professional		$156.84	$282.11	$465.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $929.98 / $1,038.21	Facility		$463.00	$929.98	$1,038.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.88 / $266.70 / $469.65	Professional		$137.88	$266.70	$469.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $167.32 / $372.31 / $1,064.32	Professional		$167.32	$372.31	$1,064.32
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 $156.36 / $162.94 / $347.95	Professional		$156.36	$162.94	$347.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $393.45	Professional		$32.34	$32.34	$393.45
United Facility/Professional Facility Modifier Low / Median / High Price $807.00 / $1,763.00 / $4,256.00	Facility		$807.00	$1,763.00	$4,256.00
United Facility/Professional Professional Modifier Low / Median / High Price $235.81 / $364.13 / $536.54	Professional		$235.81	$364.13	$536.54