Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.40 / $1,958.00 / $4,933.00	Facility		$111.40	$1,958.00	$4,933.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.46 / $22.28 / $49.29	Facility	53	$21.46	$22.28	$49.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $167.37 / $246.48	Professional		$76.23	$167.37	$246.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.78 / $83.41 / $112.60	Professional		$76.78	$83.41	$112.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $989.99 / $1,346.18 / $3,291.90	Facility		$989.99	$1,346.18	$3,291.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.82 / $90.37 / $150.30	Professional		$21.82	$90.37	$150.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $178.80 / $400.18	Professional		$86.29	$178.80	$400.18
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $198.60 / $1,424.09 / $4,933.00	Facility		$198.60	$1,424.09	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $21.46 / $21.46 / $47.46	Facility	53	$21.46	$21.46	$47.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $90.92 / $198.60 / $313.24	Professional		$90.92	$198.60	$313.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.21 / $198.68 / $279.32	Professional		$162.21	$198.68	$279.32
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,438.00 / $2,029.00	Facility		$464.00	$1,438.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.27 / $244.38 / $328.42	Professional		$204.27	$244.38	$328.42