Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.68 / $893.28 / $3,929.19	Facility		$128.68	$893.28	$3,929.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $166.62 / $293.63	Professional		$87.98	$166.62	$293.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $72.70 / $157.85	Professional		$72.70	$72.70	$157.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,001.58 / $1,480.83 / $2,044.43	Facility		$1,001.58	$1,480.83	$2,044.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.33 / $106.13 / $185.26	Professional		$29.33	$106.13	$185.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $203.12 / $437.52	Professional		$103.40	$203.12	$437.52
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $135.11 / $893.28 / $4,200.16	Facility		$135.11	$893.28	$4,200.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $196.53 / $335.98	Professional		$109.71	$196.53	$335.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.05 / $183.49 / $282.54	Professional		$32.05	$183.49	$282.54
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.92 / $254.06 / $367.37	Professional		$192.92	$254.06	$367.37