Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $512.86 / $912.01	Professional		$416.87	$512.86	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $2,570.40	Facility		$1,412.54	$1,659.59	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $562.34 / $741.31	Professional		$549.54	$562.34	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $977.24	Professional		$446.68	$616.60	$977.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,202.26 / $1,659.59	Professional		$524.81	$1,202.26	$1,659.59
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 $602.56 / $616.60 / $660.69	Professional		$602.56	$616.60	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $676.08	Professional		$32.36	$33.11	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $549.54 / $831.76	Professional		$416.87	$549.54	$831.76