Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.35 / $506.84 / $4,933.00	Facility		$243.35	$506.84	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $182.51 / $189.53 / $201.41	Facility	54	$182.51	$189.53	$201.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $242.94 / $365.31	Professional		$163.97	$242.94	$365.31
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.65 / $182.51 / $201.41	Professional	54	$127.65	$182.51	$201.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.80 / $197.80 / $353.98	Professional		$197.80	$197.80	$353.98
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $184.01 / $184.01 / $184.01	Professional	54	$184.01	$184.01	$184.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.37 / $262.17 / $355.20	Facility		$223.37	$262.17	$355.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $301.27 / $502.66	Professional		$53.78	$301.27	$502.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.76 / $215.61 / $405.21	Professional		$146.76	$215.61	$405.21
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $196.17 / $506.84 / $4,933.00	Facility		$196.17	$506.84	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $182.51 / $182.51 / $193.95	Facility	54	$182.51	$182.51	$193.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $180.37 / $253.45 / $358.42	Professional		$180.37	$253.45	$358.42
Health Alliance Plan Facility/Professional Professional Modifier 54 Low / Median / High Price $145.47 / $193.95 / $251.55	Professional	54	$145.47	$193.95	$251.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $135.89 / $233.70	Professional		$30.69	$135.89	$233.70
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 $189.62 / $229.56 / $315.61	Professional		$189.62	$229.56	$315.61