Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.96 / $1,055.00 / $5,091.00	Facility		$207.96	$1,055.00	$5,091.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,348.19 / $1,348.19 / $1,602.40	Facility	50	$1,348.19	$1,348.19	$1,602.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.17 / $139.02 / $232.80	Professional		$104.17	$139.02	$232.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.06 / $150.62 / $564.00	Professional	50	$85.06	$150.62	$564.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.27 / $120.27 / $120.27	Professional		$120.27	$120.27	$120.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $411.32 / $1,218.20 / $2,657.06	Facility		$411.32	$1,218.20	$2,657.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $205.48 / $231.11	Professional		$132.94	$205.48	$231.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.13 / $170.16 / $254.44	Professional		$113.13	$170.16	$254.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $187.47 / $403.93	Professional		$110.10	$187.47	$403.93
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 $140.97 / $141.38 / $174.08	Professional		$140.97	$141.38	$174.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $196.85	Professional		$32.34	$32.34	$196.85
United Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $963.00 / $3,686.00	Facility		$150.00	$963.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $156.22 / $300.04	Professional		$114.04	$156.22	$300.04