Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $2,056.00 / $5,397.52	Facility		$464.00	$2,056.00	$5,397.52
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,140.51 / $3,140.51 / $3,140.51	Facility	50	$3,140.51	$3,140.51	$3,140.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.29 / $221.40 / $657.50	Professional		$129.29	$221.40	$657.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.85 / $178.52 / $480.06	Professional		$163.85	$178.52	$480.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,525.95 / $2,074.96 / $4,872.80	Facility		$1,525.95	$2,074.96	$4,872.80
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $823.40 / $1,265.84 / $1,579.95	Facility	50	$823.40	$1,265.84	$1,579.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $193.69 / $321.27	Professional		$35.39	$193.69	$321.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.44 / $233.33 / $847.28	Professional		$118.44	$233.33	$847.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $305.18 / $1,958.00 / $4,933.00	Facility		$305.18	$1,958.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,140.51 / $3,140.51 / $3,140.51	Facility	50	$3,140.51	$3,140.51	$3,140.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $130.65 / $590.71 / $774.59	Professional		$130.65	$590.71	$774.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $380.46 / $476.36 / $682.38	Professional		$380.46	$476.36	$682.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $193.81 / $642.58 / $879.85	Professional		$193.81	$642.58	$879.85