Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.91 / $2,877.00 / $4,933.00	Facility		$157.91	$2,877.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $1,490.13 / $1,831.81	Professional		$109.37	$1,490.13	$1,831.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,685.28 / $2,685.28 / $2,685.28	Professional	50	$2,685.28	$2,685.28	$2,685.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.54 / $1,179.56 / $1,469.93	Professional		$163.54	$1,179.56	$1,469.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,769.34 / $1,769.34 / $1,769.34	Professional	50	$1,769.34	$1,769.34	$1,769.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,556.28 / $2,108.73 / $3,264.97	Facility		$1,556.28	$2,108.73	$3,264.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.97 / $176.28 / $356.98	Professional		$29.97	$176.28	$356.98
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $282.81 / $282.81 / $2,922.38	Professional	50	$282.81	$282.81	$2,922.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.46 / $237.73 / $2,318.94	Professional		$124.46	$237.73	$2,318.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,523.62 / $2,877.00 / $4,933.00	Facility		$1,523.62	$2,877.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $1,523.62 / $1,980.70	Professional		$157.91	$1,523.62	$1,980.70
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $2,685.28 / $2,685.28 / $2,685.28	Professional	50	$2,685.28	$2,685.28	$2,685.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $986.99 / $1,223.27 / $1,768.40	Professional		$986.99	$1,223.27	$1,768.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $3,640.00 / $6,740.00	Facility		$1,527.00	$3,640.00	$6,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,590.31 / $2,015.07 / $2,732.51	Professional		$1,590.31	$2,015.07	$2,732.51