Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.50 / $306.51 / $4,933.00	Facility		$104.50	$306.51	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $646.42 / $646.42 / $646.42	Facility	50	$646.42	$646.42	$646.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $169.27 / $318.30	Professional		$71.48	$169.27	$318.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $297.12 / $394.06 / $403.72	Professional	50	$297.12	$394.06	$403.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.23 / $81.23 / $105.60	Professional		$81.23	$81.23	$105.60
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.64 / $112.64 / $112.64	Professional	50	$112.64	$112.64	$112.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $300.94 / $351.29 / $478.55	Facility		$300.94	$351.29	$478.55
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $163.27 / $221.57 / $312.05	Facility	50	$163.27	$221.57	$312.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.62 / $121.31 / $233.94	Professional		$20.62	$121.31	$233.94
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $185.34 / $185.34 / $576.80	Professional	50	$185.34	$185.34	$576.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $171.24 / $328.06	Professional		$78.06	$171.24	$328.06
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $109.72 / $318.30 / $4,933.00	Facility		$109.72	$318.30	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $646.42 / $646.42 / $646.42	Facility	50	$646.42	$646.42	$646.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $204.12 / $348.33	Professional		$100.62	$204.12	$348.33
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $394.06 / $394.06 / $403.72	Professional	50	$394.06	$394.06	$403.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.70 / $238.43 / $341.35	Professional		$190.70	$238.43	$341.35
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,247.00 / $1,844.00	Facility		$464.00	$1,247.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $200.62 / $258.11 / $372.80	Professional		$200.62	$258.11	$372.80