Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.79 / $3,776.00 / $9,727.00	Facility		$145.79	$3,776.00	$9,727.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $143.50 / $246.72	Professional		$97.29	$143.50	$246.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.84 / $253.31 / $1,050.00	Professional	50	$164.84	$253.31	$1,050.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $107.55 / $215.11	Professional		$60.28	$107.55	$215.11
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $131.34 / $131.34 / $322.66	Professional	50	$131.34	$131.34	$322.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $411.66 / $793.85 / $1,268.71	Facility		$411.66	$793.85	$1,268.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.57 / $130.44 / $270.56	Professional		$112.57	$130.44	$270.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.61 / $148.61 / $148.61	Facility		$148.61	$148.61	$148.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.32 / $165.56 / $312.23	Professional		$115.32	$165.56	$312.23
Medcost Facility/Professional Facility Modifier Low / Median / High Price $118.20 / $170.79 / $266.26	Facility		$118.20	$170.79	$266.26
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $190.50 / $264.00 / $399.39	Facility	50	$190.50	$264.00	$399.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.96 / $154.96 / $154.96	Professional		$154.96	$154.96	$154.96
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $232.44 / $232.44 / $232.44	Professional	50	$232.44	$232.44	$232.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $119.79 / $159.64	Professional		$91.28	$119.79	$159.64
United Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $1,221.00 / $3,585.00	Facility		$225.00	$1,221.00	$3,585.00
United Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $151.58 / $253.97	Professional		$115.33	$151.58	$253.97