Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $213.80 / $4,897.79	Facility		$54.95	$213.80	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $123.03	Professional		$32.36	$44.67	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $40.74 / $44.67	Professional		$25.70	$40.74	$44.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $51.29	Facility		$31.62	$31.62	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $51.29 / $54.95	Professional		$11.22	$51.29	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $97.72	Professional		$30.20	$48.98	$97.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $158.49 / $4,897.79	Facility		$54.95	$158.49	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $95.50	Professional		$33.88	$53.70	$95.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $75.86	Professional		$28.84	$46.77	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $870.96 / $1,737.80	Facility		$234.42	$870.96	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $70.79	Professional		$37.15	$48.98	$70.79