Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.50 / $394.13 / $2,056.00	Facility		$172.50	$394.13	$2,056.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.18 / $181.13 / $268.58	Professional		$132.18	$181.13	$268.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $139.66 / $203.38	Professional		$139.66	$139.66	$203.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $772.26 / $1,141.79 / $1,576.36	Facility		$772.26	$1,141.79	$1,576.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.42 / $196.33 / $334.80	Professional		$37.42	$196.33	$334.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $200.27 / $394.15	Professional		$136.94	$200.27	$394.15
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $172.50 / $469.80 / $4,933.00	Facility		$172.50	$469.80	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $146.19 / $194.30 / $315.93	Professional		$146.19	$194.30	$315.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.21 / $171.39 / $249.95	Professional		$122.21	$171.39	$249.95
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,438.00 / $1,844.00	Facility		$300.00	$1,438.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.05 / $246.31 / $315.27	Professional		$197.05	$246.31	$315.27