Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.01 / $849.00 / $4,500.00	Facility		$137.01	$849.00	$4,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $86.54 / $181.83	Professional		$63.66	$86.54	$181.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.06 / $102.06 / $114.72	Professional		$102.06	$102.06	$114.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $428.52 / $916.64 / $1,835.57	Facility		$428.52	$916.64	$1,835.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $115.65 / $171.84	Professional		$87.64	$115.65	$171.84
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 $77.63 / $116.25 / $182.11	Professional		$77.63	$116.25	$182.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.65 / $148.27 / $308.68	Professional		$95.65	$148.27	$308.68
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 $79.86 / $88.82 / $129.69	Professional		$79.86	$88.82	$129.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $146.65	Professional		$32.34	$32.34	$146.65
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 $87.99 / $133.18 / $203.45	Professional		$87.99	$133.18	$203.45