Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.57 / $2,056.00 / $4,933.00	Facility		$403.57	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $302.68 / $314.32 / $351.20	Facility	54	$302.68	$314.32	$351.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.37 / $403.57 / $609.13	Professional		$269.37	$403.57	$609.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.64 / $302.64 / $513.99	Professional		$302.64	$302.64	$513.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $254.44 / $298.14 / $424.76	Facility		$254.44	$298.14	$424.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $519.74 / $853.85	Professional		$92.57	$519.74	$853.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.64 / $363.07 / $675.39	Professional		$266.64	$363.07	$675.39
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $336.26 / $2,056.00 / $4,933.00	Facility		$336.26	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $302.68 / $302.68 / $338.19	Facility	54	$302.68	$302.68	$338.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $408.08 / $584.84	Professional		$336.26	$408.08	$584.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $225.28 / $401.02	Professional		$33.81	$225.28	$401.02
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 $327.56 / $393.81 / $542.91	Professional		$327.56	$393.81	$542.91