Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.11 / $1,094.00 / $5,091.00	Facility		$104.11	$1,094.00	$5,091.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $146.78 / $256.36	Professional		$61.11	$146.78	$256.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.87 / $123.87 / $123.87	Professional		$123.87	$123.87	$123.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.91 / $457.20 / $997.22	Facility		$258.91	$457.20	$997.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $122.61 / $254.23	Professional		$56.73	$122.61	$254.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $258.58 / $289.75 / $554.38	Facility		$258.58	$289.75	$554.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $140.82 / $250.68	Professional		$61.48	$140.82	$250.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $178.85 / $394.74	Professional		$63.00	$178.85	$394.74
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 $61.62 / $62.15 / $183.08	Professional		$61.62	$62.15	$183.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $211.25	Professional		$32.34	$32.34	$211.25
United Facility/Professional Professional Modifier Low / Median / High Price $147.87 / $193.95 / $375.32	Professional		$147.87	$193.95	$375.32