Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.08 / $459.46 / $953.60	Facility		$114.08	$459.46	$953.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.86 / $93.42 / $311.39	Professional		$81.86	$93.42	$311.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.00 / $420.00 / $420.00	Professional		$420.00	$420.00	$420.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $458.44 / $732.68 / $1,406.19	Facility		$458.44	$732.68	$1,406.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.95 / $116.95 / $116.95	Professional		$116.95	$116.95	$116.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $86.98 / $86.98	Facility		$86.98	$86.98	$86.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $86.98 / $86.98	Professional		$86.98	$86.98	$86.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $185.40 / $662.74 / $1,169.54	Professional		$185.40	$662.74	$1,169.54
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 $1,013.60 / $1,013.60 / $1,013.60	Professional		$1,013.60	$1,013.60	$1,013.60
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 Facility Modifier Low / Median / High Price $85.27 / $85.27 / $85.27	Facility		$85.27	$85.27	$85.27
United Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $93.48	Professional		$85.27	$85.27	$93.48