Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $2,041.74 / $4,897.79	Facility		$147.91	$2,041.74	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $288.40	Professional		$104.71	$151.36	$288.40
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $95.50 / $218.78 / $309.03	Professional	54	$95.50	$218.78	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $134.90	Professional		$97.72	$117.49	$134.90
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $38.02 / $69.18 / $117.49	Professional	54	$38.02	$69.18	$117.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $190.55 / $190.55	Facility		$38.02	$190.55	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $281.84	Professional		$190.55	$204.17	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $144.54 / $213.80	Professional		$91.20	$144.54	$213.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $489.78 / $4,897.79	Facility		$147.91	$489.78	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $257.04	Professional		$112.20	$151.36	$257.04
Health Alliance Plan Facility/Professional Professional Modifier 54 Low / Median / High Price $158.49 / $269.15 / $316.23	Professional	54	$158.49	$269.15	$316.23
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $213.80	Professional		$89.13	$141.25	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $794.33 / $1,737.80	Facility		$186.21	$794.33	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $181.97	Professional		$112.20	$138.04	$181.97