Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.10 / $326.62 / $4,933.00	Facility		$111.10	$326.62	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $55.56 / $55.56 / $163.31	Facility	52	$55.56	$55.56	$163.31
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.22 / $22.22 / $65.31	Facility	53	$22.22	$22.22	$65.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.57 / $192.56 / $326.62	Professional		$89.57	$192.56	$326.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $78.26 / $163.34	Professional		$78.26	$78.26	$163.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.57 / $1,091.97 / $1,507.57	Facility		$738.57	$1,091.97	$1,507.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.18 / $90.70 / $156.56	Professional		$22.18	$90.70	$156.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.81 / $225.53 / $489.90	Professional		$93.81	$225.53	$489.90
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $111.11 / $411.54 / $4,933.00	Facility		$111.11	$411.54	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $55.56 / $55.56 / $163.31	Facility	52	$55.56	$55.56	$163.31
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $22.22 / $22.22 / $65.31	Facility	53	$22.22	$22.22	$65.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $99.81 / $234.27 / $394.68	Professional		$99.81	$234.27	$394.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $188.33 / $236.97 / $340.87	Professional		$188.33	$236.97	$340.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $4,857.00 / $6,036.00	Facility		$1,050.00	$4,857.00	$6,036.00
United Facility/Professional Professional Modifier Low / Median / High Price $236.23 / $302.26 / $402.34	Professional		$236.23	$302.26	$402.34