Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.05 / $849.00 / $3,221.00	Facility		$190.05	$849.00	$3,221.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $134.88 / $280.33	Professional		$94.41	$134.88	$280.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Professional		$80.04	$80.04	$80.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $827.72 / $1,241.66 / $2,487.11	Facility		$827.72	$1,241.66	$2,487.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $191.18 / $281.50	Professional		$137.47	$191.18	$281.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.02 / $181.99 / $908.00	Facility		$163.02	$181.99	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.98 / $181.40 / $286.45	Professional		$119.98	$181.40	$286.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.26 / $241.01 / $482.69	Professional		$148.26	$241.01	$482.69
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 $122.69 / $137.66 / $214.38	Professional		$122.69	$137.66	$214.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $242.42	Professional		$32.34	$32.34	$242.42
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 $136.10 / $199.25 / $318.10	Professional		$136.10	$199.25	$318.10