Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.96 / $812.21 / $4,933.00	Facility		$93.96	$812.21	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.98 / $93.92 / $194.04	Professional		$64.98	$93.92	$194.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $97.82 / $124.46	Professional		$72.45	$97.82	$124.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,255.76 / $1,473.89 / $1,996.89	Facility		$1,255.76	$1,473.89	$1,996.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $110.78 / $217.52	Professional		$18.84	$110.78	$217.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $96.00 / $166.59	Professional		$62.05	$96.00	$166.59
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $92.54 / $812.21 / $4,933.00	Facility		$92.54	$812.21	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $82.32 / $104.73 / $203.89	Professional		$82.32	$104.73	$203.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $67.99 / $96.85	Professional		$54.90	$67.99	$96.85
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $114.98 / $152.47	Professional		$95.25	$114.98	$152.47