Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.28 / $338.56 / $4,933.00	Facility		$66.28	$338.56	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,232.86 / $2,232.86 / $3,057.92	Facility	50	$2,232.86	$2,232.86	$3,057.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.78 / $161.13 / $404.53	Professional		$46.78	$161.13	$404.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $229.89 / $229.89 / $528.66	Professional	50	$229.89	$229.89	$528.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.84 / $43.84 / $48.96	Professional		$43.84	$43.84	$48.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,478.15 / $3,390.00 / $8,148.62	Facility		$2,478.15	$3,390.00	$8,148.62
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,322.32 / $1,948.43 / $2,642.18	Facility	50	$1,322.32	$1,948.43	$2,642.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.37 / $58.43 / $137.86	Professional		$12.37	$58.43	$137.86
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $104.44 / $141.30 / $633.66	Professional	50	$104.44	$141.30	$633.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.37 / $80.37 / $80.37	Facility		$80.37	$80.37	$80.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $187.66 / $542.01	Professional		$47.97	$187.66	$542.01
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $66.28 / $341.30 / $4,933.00	Facility		$66.28	$341.30	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,232.86 / $2,232.86 / $3,057.92	Facility	50	$2,232.86	$2,232.86	$3,057.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $47.13 / $326.47 / $438.28	Professional		$47.13	$326.47	$438.28
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $229.89 / $229.89 / $528.66	Professional	50	$229.89	$229.89	$528.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.30 / $231.11 / $326.53	Professional		$186.30	$231.11	$326.53
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,438.00 / $2,029.00	Facility		$464.00	$1,438.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $282.87 / $401.73 / $530.28	Professional		$282.87	$401.73	$530.28