Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.33 / $2,740.00 / $4,933.00	Facility		$199.33	$2,740.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.71 / $164.22 / $241.61	Professional		$146.71	$164.22	$241.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $140.06 / $341.85	Professional		$74.23	$140.06	$341.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,189.36 / $1,412.23 / $1,939.66	Facility		$1,189.36	$1,412.23	$1,939.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $146.28 / $250.32	Professional		$41.37	$146.28	$250.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.19 / $200.40 / $402.53	Professional		$153.19	$200.40	$402.53
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $179.50 / $2,740.00 / $4,933.00	Facility		$179.50	$2,740.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $147.03 / $179.50 / $265.49	Professional		$147.03	$179.50	$265.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.95 / $170.12 / $244.97	Professional		$136.95	$170.12	$244.97
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 $164.93 / $219.07 / $286.85	Professional		$164.93	$219.07	$286.85