Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.54 / $848.30 / $3,621.00	Facility		$93.54	$848.30	$3,621.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $280.00 / $2,127.92 / $4,189.05	Facility	50	$280.00	$2,127.92	$4,189.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $93.12 / $216.86	Professional		$55.09	$93.12	$216.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $89.90 / $146.91 / $508.59	Professional	50	$89.90	$146.91	$508.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $196.34 / $196.34 / $196.34	Professional	50	$196.34	$196.34	$196.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $343.40 / $734.56 / $1,470.95	Facility		$343.40	$734.56	$1,470.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $110.51 / $175.39	Professional		$72.44	$110.51	$175.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $107.73 / $178.96	Professional		$65.61	$107.73	$178.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $151.32 / $527.88	Professional		$83.78	$151.32	$527.88
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 $70.30 / $75.11 / $130.69	Professional		$70.30	$75.11	$130.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $147.79	Professional		$32.34	$32.34	$147.79
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $88.53 / $137.16 / $207.60	Professional		$88.53	$137.16	$207.60