Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.75 / $716.23 / $2,878.00	Facility		$148.75	$716.23	$2,878.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,700.35 / $2,700.35 / $2,700.35	Facility	50	$2,700.35	$2,700.35	$2,700.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $410.73 / $828.77	Professional		$115.83	$410.73	$828.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $987.86 / $987.86 / $987.86	Professional	50	$987.86	$987.86	$987.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $102.70 / $219.97	Professional		$43.93	$102.70	$219.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $329.95 / $329.95 / $329.95	Professional	50	$329.95	$329.95	$329.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,230.51 / $3,033.03 / $7,416.87	Facility		$2,230.51	$3,033.03	$7,416.87
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,284.56 / $1,773.46 / $2,404.91	Facility	50	$1,284.56	$1,773.46	$2,404.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $163.65 / $318.64	Professional		$26.75	$163.65	$318.64
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $252.45 / $252.45 / $1,214.33	Professional	50	$252.45	$252.45	$1,214.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $181.74 / $181.74	Facility		$181.74	$181.74	$181.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.93 / $370.94 / $1,076.58	Professional		$116.93	$370.94	$1,076.58
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $148.75 / $1,575.00 / $4,933.00	Facility		$148.75	$1,575.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,700.35 / $2,700.35 / $2,700.35	Facility	50	$2,700.35	$2,700.35	$2,700.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $536.73 / $849.85	Professional		$117.70	$536.73	$849.85
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $987.86 / $987.86 / $987.86	Professional	50	$987.86	$987.86	$987.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $398.61 / $493.41 / $696.64	Professional		$398.61	$493.41	$696.64
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 $542.79 / $713.74 / $1,097.28	Professional		$542.79	$713.74	$1,097.28