Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $151.36 / $19,054.61	Facility		$87.10	$151.36	$19,054.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $11,748.98	Professional		$85.11	$87.10	$11,748.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $295.12 / $1,621.81	Facility		$128.82	$295.12	$1,621.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $104.71	Professional		$93.33	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $229.09	Professional		$85.11	$154.88	$229.09
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 $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $125.89	Professional		$87.10	$117.49	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $138.04	Facility		$85.11	$85.11	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $95.50	Professional		$87.10	$91.20	$95.50