Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,621.81 / $5,623.41	Facility		$158.49	$1,621.81	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $158.49 / $426.58	Professional		$61.66	$158.49	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $131.83	Professional		$112.20	$117.49	$131.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $309.03 / $933.25	Facility		$257.04	$309.03	$933.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $257.04	Professional		$56.23	$109.65	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $389.05 / $549.54	Facility		$257.04	$389.05	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $141.25 / $251.19	Professional		$58.88	$141.25	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $186.21 / $426.58	Professional		$61.66	$186.21	$426.58
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 $61.66 / $61.66 / $181.97	Professional		$61.66	$61.66	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $478.63 / $691.83	Facility		$302.00	$478.63	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $141.25 / $263.03	Professional		$64.57	$141.25	$263.03