Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.03 / $4,112.00 / $4,933.00	Facility		$160.03	$4,112.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.30 / $160.03 / $167.21	Professional		$137.30	$160.03	$167.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.51 / $121.51 / $121.51	Professional		$121.51	$121.51	$121.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,282.84 / $4,991.80 / $6,763.10	Facility		$4,282.84	$4,991.80	$6,763.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $123.25 / $186.15	Professional		$31.35	$123.25	$186.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.84 / $191.21 / $250.36	Professional		$95.84	$191.21	$250.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.95 / $4,112.00 / $4,933.00	Facility		$169.95	$4,112.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $134.77 / $169.95 / $222.85	Professional		$134.77	$169.95	$222.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.28 / $103.04 / $147.54	Professional		$83.28	$103.04	$147.54
United Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $10,092.00 / $15,216.40	Facility		$5,000.00	$10,092.00	$15,216.40
United Facility/Professional Professional Modifier Low / Median / High Price $138.81 / $192.30 / $250.85	Professional		$138.81	$192.30	$250.85