Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.98 / $421.53 / $4,933.00	Facility		$217.98	$421.53	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $276.39 / $287.02 / $301.10	Facility	54	$276.39	$287.02	$301.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.84 / $355.01 / $524.16	Professional		$244.84	$355.01	$524.16
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $194.32 / $276.39 / $301.10	Professional	54	$194.32	$276.39	$301.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $319.13 / $441.48	Professional		$159.56	$319.13	$441.48
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $213.57 / $213.57 / $295.42	Professional	54	$213.57	$213.57	$295.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $255.91 / $299.77 / $421.75	Facility		$255.91	$299.77	$421.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $377.29 / $599.51	Professional		$61.08	$377.29	$599.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.79 / $318.95 / $617.73	Professional		$216.79	$318.95	$617.73
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $217.98 / $401.83 / $4,933.00	Facility		$217.98	$401.83	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $276.39 / $276.39 / $289.94	Facility	54	$276.39	$276.39	$289.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $263.83 / $380.32 / $517.45	Professional		$263.83	$380.32	$517.45
Health Alliance Plan Facility/Professional Professional Modifier 54 Low / Median / High Price $218.50 / $289.94 / $376.06	Professional	54	$218.50	$289.94	$376.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $195.22 / $360.97	Professional		$33.81	$195.22	$360.97
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 $264.63 / $330.73 / $468.98	Professional		$264.63	$330.73	$468.98