Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $326.87 / $826.53 / $4,933.00	Facility		$326.87	$826.53	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $163.44 / $163.44 / $413.27	Facility	52	$163.44	$163.44	$413.27
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $65.38 / $65.38 / $165.31	Facility	53	$65.38	$65.38	$165.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.25 / $531.65 / $867.85	Professional		$281.25	$531.65	$867.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.36 / $228.59 / $459.39	Professional		$219.36	$228.59	$459.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.10 / $1,277.57 / $1,763.81	Facility		$864.10	$1,277.57	$1,763.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $264.83 / $411.44	Professional		$64.76	$264.83	$411.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.77 / $605.40 / $1,230.08	Professional		$275.77	$605.40	$1,230.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $332.76 / $1,070.85 / $4,933.00	Facility		$332.76	$1,070.85	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $163.44 / $163.44 / $413.27	Facility	52	$163.44	$163.44	$413.27
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $65.38 / $65.38 / $165.31	Facility	53	$65.38	$65.38	$165.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $312.07 / $624.64 / $1,045.85	Professional		$312.07	$624.64	$1,045.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $536.61 / $674.54 / $971.34	Professional		$536.61	$674.54	$971.34
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 $650.26 / $836.24 / $1,138.52	Professional		$650.26	$836.24	$1,138.52