Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.77 / $439.11 / $4,933.00	Facility		$288.77	$439.11	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $216.59 / $221.10 / $229.61	Facility	54	$216.59	$221.10	$229.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.84 / $288.77 / $401.89	Professional		$184.84	$288.77	$401.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.62 / $225.46 / $330.98	Professional		$171.62	$225.46	$330.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.97 / $293.98 / $396.31	Facility		$250.97	$293.98	$396.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $261.29 / $572.54	Professional		$64.89	$261.29	$572.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.08 / $252.10 / $480.49	Professional		$172.08	$252.10	$480.49
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $218.15 / $451.74 / $4,933.00	Facility		$218.15	$451.74	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $216.59 / $216.59 / $221.10	Facility	54	$216.59	$216.59	$221.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $201.80 / $294.80 / $410.62	Professional		$201.80	$294.80	$410.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $162.92 / $246.46	Professional		$30.69	$162.92	$246.46
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $215.05 / $255.71 / $377.05	Professional		$215.05	$255.71	$377.05