Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.97 / $925.99 / $4,624.42	Facility		$288.97	$925.99	$4,624.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.51 / $206.41 / $262.35	Professional		$118.51	$206.41	$262.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.75 / $177.75 / $177.75	Professional		$177.75	$177.75	$177.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $636.07 / $1,125.36 / $2,617.94	Facility		$636.07	$1,125.36	$2,617.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.61 / $193.12 / $202.31	Professional		$173.61	$193.12	$202.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $285.68 / $692.23 / $1,484.21	Facility		$285.68	$692.23	$1,484.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.65 / $328.71 / $527.77	Professional		$233.65	$328.71	$527.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.61 / $262.64 / $855.59	Professional		$173.61	$262.64	$855.59
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 $205.18 / $210.72 / $239.10	Professional		$205.18	$210.72	$239.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.61 / $295.35 / $844.96	Professional		$150.61	$295.35	$844.96