Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.05 / $147.54 / $4,933.00	Facility		$65.05	$147.54	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $93.72 / $148.03	Professional		$57.40	$93.72	$148.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.23 / $48.23 / $48.23	Professional		$48.23	$48.23	$48.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $538.80 / $628.95 / $856.80	Facility		$538.80	$628.95	$856.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.01 / $55.27 / $87.48	Professional		$11.01	$55.27	$87.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $107.87 / $189.28	Professional		$58.88	$107.87	$189.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.96 / $147.54 / $4,933.00	Facility		$81.96	$147.54	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $123.54 / $172.27	Professional		$65.04	$123.54	$172.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $102.47 / $146.41	Professional		$81.79	$102.47	$146.41
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $121.26 / $153.53 / $217.75	Professional		$121.26	$153.53	$217.75