Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $354.81 / $758.58	Facility		$204.17	$354.81	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $208.93 / $1,445.44	Professional		$204.17	$208.93	$1,445.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,148.15 / $3,388.44	Facility		$446.68	$1,148.15	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $213.80	Professional		$204.17	$204.17	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $416.87	Professional		$194.98	$288.40	$416.87
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 $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $204.17 / $338.84	Facility		$81.28	$204.17	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $213.80	Professional		$194.98	$204.17	$213.80