Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.97 / $515.27 / $4,933.00	Facility		$134.97	$515.27	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.98 / $147.63 / $205.05	Professional		$113.98	$147.63	$205.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.72 / $229.72 / $229.72	Professional		$229.72	$229.72	$229.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $134.18 / $180.84	Facility		$115.00	$134.18	$180.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $110.38 / $228.17	Professional		$28.87	$110.38	$228.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.43 / $167.18 / $259.02	Professional		$115.43	$167.18	$259.02
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $151.58 / $515.27 / $4,933.00	Facility		$151.58	$515.27	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $170.16 / $255.70	Professional		$131.00	$170.16	$255.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $170.59 / $244.30	Professional		$137.22	$170.59	$244.30
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 $164.52 / $197.10 / $258.72	Professional		$164.52	$197.10	$258.72