Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.30 / $276.25 / $4,933.00	Facility		$170.30	$276.25	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.62 / $206.15 / $280.94	Professional		$133.62	$206.15	$280.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.03 / $180.83 / $180.83	Professional		$129.03	$180.83	$180.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $506.11 / $590.78 / $804.81	Facility		$506.11	$590.78	$804.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $131.69 / $260.89	Professional		$34.11	$131.69	$260.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $196.93 / $343.88	Professional		$135.47	$196.93	$343.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $205.83 / $956.83 / $4,933.00	Facility		$205.83	$956.83	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $170.30 / $220.84 / $330.62	Professional		$170.30	$220.84	$330.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $204.94 / $292.83	Professional		$163.59	$204.94	$292.83
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $232.25 / $279.20 / $364.82	Professional		$232.25	$279.20	$364.82