Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $2,877.00 / $6,377.70	Facility		$379.00	$2,877.00	$6,377.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,287.66 / $4,287.66 / $16,751.20	Facility	50	$4,287.66	$4,287.66	$16,751.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.95 / $1,028.97 / $1,823.55	Professional		$263.95	$1,028.97	$1,823.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $303.19 / $303.19 / $303.19	Professional		$303.19	$303.19	$303.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,870.93 / $6,163.52 / $14,138.64	Facility		$2,870.93	$6,163.52	$14,138.64
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,090.30 / $3,829.78 / $4,897.54	Facility	50	$2,090.30	$3,829.78	$4,897.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.12 / $399.76 / $675.38	Professional		$75.12	$399.76	$675.38
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $675.08 / $675.08 / $675.08	Professional	50	$675.08	$675.08	$675.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.50 / $482.50 / $482.50	Facility		$482.50	$482.50	$482.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.66 / $1,002.28 / $2,506.21	Professional		$290.66	$1,002.28	$2,506.21
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $400.11 / $2,877.00 / $6,377.70	Facility		$400.11	$2,877.00	$6,377.70
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $4,287.66 / $4,287.66 / $16,751.20	Facility	50	$4,287.66	$4,287.66	$16,751.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $365.02 / $1,413.13 / $1,991.80	Professional		$365.02	$1,413.13	$1,991.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $923.87 / $1,156.52 / $1,631.07	Professional		$923.87	$1,156.52	$1,631.07
United Facility/Professional Facility Modifier Low / Median / High Price $3,296.00 / $7,500.00 / $9,202.00	Facility		$3,296.00	$7,500.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,282.99 / $1,778.79 / $2,520.39	Professional		$1,282.99	$1,778.79	$2,520.39