Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $501.19	Facility		$251.19	$251.19	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $251.19 / $478.63	Professional		$223.87	$251.19	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $954.99 / $3,388.44	Facility		$588.84	$954.99	$3,388.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $371.54 / $371.54	Professional		$323.59	$371.54	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $549.54	Facility		$295.12	$295.12	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $537.03	Professional		$218.78	$218.78	$537.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $691.83	Professional		$416.87	$562.34	$691.83
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 $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $371.54	Professional		$257.04	$257.04	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $389.05 / $741.31	Facility		$190.55	$389.05	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $389.05	Professional		$186.21	$245.47	$389.05