Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.52 / $1,919.96 / $4,933.00	Facility		$148.52	$1,919.96	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $74.26 / $74.26 / $303.42	Facility	52	$74.26	$74.26	$303.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.31 / $170.41 / $613.62	Professional		$118.31	$170.41	$613.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.28 / $217.28 / $217.28	Professional		$217.28	$217.28	$217.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $740.96 / $1,095.51 / $1,512.47	Facility		$740.96	$1,095.51	$1,512.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $114.06 / $199.87	Professional		$30.73	$114.06	$199.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $259.35 / $925.01	Professional		$122.95	$259.35	$925.01
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.84 / $2,056.00 / $4,933.00	Facility		$169.84	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $74.26 / $74.26 / $303.42	Facility	52	$74.26	$74.26	$303.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $148.52 / $210.53 / $644.88	Professional		$148.52	$210.53	$644.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $376.67 / $473.94 / $681.74	Professional		$376.67	$473.94	$681.74
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 $203.40 / $515.30 / $861.45	Professional		$203.40	$515.30	$861.45