Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $4,897.79 / $8,128.31	Facility		$1,096.48	$4,897.79	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,698.24	Professional		$1,096.48	$1,096.48	$1,698.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $4,897.79 / $8,128.31	Facility		$1,096.48	$4,897.79	$8,128.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $2,290.87	Professional		$1,096.48	$1,096.48	$2,290.87
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $7,244.36 / $12,882.50	Facility		$3,467.37	$7,244.36	$12,882.50