Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.40 / $625.21 / $4,933.00	Facility		$191.40	$625.21	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $73.14 / $75.95 / $112.63	Facility	52	$73.14	$75.95	$112.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.10 / $178.90 / $320.87	Professional		$117.10	$178.90	$320.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.98 / $54.98 / $54.98	Professional		$54.98	$54.98	$54.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $910.20 / $1,062.47 / $1,447.38	Facility		$910.20	$1,062.47	$1,447.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $102.89 / $192.75	Professional		$29.46	$102.89	$192.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.22 / $178.54 / $273.07	Professional		$117.22	$178.54	$273.07
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $191.40 / $625.21 / $4,933.00	Facility		$191.40	$625.21	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $73.14 / $73.14 / $108.46	Facility	52	$73.14	$73.14	$108.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $146.28 / $188.23 / $368.94	Professional		$146.28	$188.23	$368.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $170.59 / $244.30	Professional		$137.22	$170.59	$244.30
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $189.18 / $215.54 / $298.47	Professional		$189.18	$215.54	$298.47