Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.93 / $973.00 / $4,634.00	Facility		$182.93	$973.00	$4,634.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $219.93 / $1,391.00 / $4,397.39	Facility	50	$219.93	$1,391.00	$4,397.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $125.47 / $325.25	Professional		$90.00	$125.47	$325.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.16 / $181.76 / $1,406.84	Professional	50	$158.16	$181.76	$1,406.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $114.30 / $135.11	Professional		$102.44	$114.30	$135.11
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $153.66 / $179.26 / $202.66	Professional	50	$153.66	$179.26	$202.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $439.11 / $953.50 / $2,079.71	Facility		$439.11	$953.50	$2,079.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $181.98 / $263.77	Professional		$105.05	$181.98	$263.77
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 $103.18 / $156.62 / $377.31	Professional		$103.18	$156.62	$377.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.55 / $173.50 / $784.70	Professional		$95.55	$173.50	$784.70
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 $109.71 / $112.78 / $149.02	Professional		$109.71	$112.78	$149.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $168.51	Professional		$32.34	$32.34	$168.51
United Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $770.00 / $3,685.00	Facility		$158.00	$770.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $180.78 / $314.23	Professional		$104.62	$180.78	$314.23