Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $333.66 / $1,186.98 / $4,133.12	Facility		$333.66	$1,186.98	$4,133.12
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $771.36 / $893.90 / $2,059.85	Facility	50	$771.36	$893.90	$2,059.85
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $170.18 / $303.37 / $405.98	Facility	54	$170.18	$303.37	$405.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.91 / $299.85 / $511.98	Professional		$226.91	$299.85	$511.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $354.30 / $586.71 / $2,796.60	Professional	50	$354.30	$586.71	$2,796.60
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $158.12 / $230.60 / $355.20	Professional	54	$158.12	$230.60	$355.20
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $30.67 / $40.76 / $64.34	Professional	55	$30.67	$40.76	$64.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.51 / $192.51 / $226.49	Professional		$192.51	$192.51	$226.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $754.86 / $2,137.61 / $4,662.39	Facility		$754.86	$2,137.61	$4,662.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.28 / $391.19 / $567.16	Professional		$232.28	$391.19	$567.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $463.00 / $480.00	Facility		$463.00	$463.00	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.48 / $332.66 / $507.29	Professional		$227.48	$332.66	$507.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.53 / $362.38 / $1,359.54	Professional		$204.53	$362.38	$1,359.54
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 $244.45 / $249.18 / $320.35	Professional		$244.45	$249.18	$320.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $362.24	Professional		$32.34	$32.34	$362.24
United Facility/Professional Facility Modifier Low / Median / High Price $553.00 / $1,905.00 / $4,342.00	Facility		$553.00	$1,905.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $371.00 / $628.48	Professional		$263.20	$371.00	$628.48