Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.26 / $765.26 / $765.26	Facility		$765.26	$765.26	$765.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $598.05 / $765.26 / $1,272.46	Professional		$598.05	$765.26	$1,272.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,116.68 / $1,116.68 / $1,116.68	Professional		$1,116.68	$1,116.68	$1,116.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,779.21 / $3,010.11 / $12,810.80	Facility		$1,779.21	$3,010.11	$12,810.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.21 / $1,131.56 / $1,131.56	Professional		$894.21	$1,131.56	$1,131.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.10 / $831.10 / $1,629.73	Facility		$831.10	$831.10	$1,629.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $606.70 / $1,091.08 / $1,507.48	Professional		$606.70	$1,091.08	$1,507.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,265.57 / $1,669.50 / $2,055.00	Professional		$1,265.57	$1,669.50	$2,055.00
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 $1,935.57 / $1,935.57 / $1,935.57	Professional		$1,935.57	$1,935.57	$1,935.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $970.82 / $1,386.89 / $1,456.23	Professional		$970.82	$1,386.89	$1,456.23
United Facility/Professional Professional Modifier Low / Median / High Price $552.96 / $742.79 / $1,275.13	Professional		$552.96	$742.79	$1,275.13