Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $774.67 / $2,056.00 / $6,906.00	Facility		$774.67	$2,056.00	$6,906.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $581.00 / $602.52 / $692.31	Facility	54	$581.00	$602.52	$692.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.96 / $690.09 / $969.23	Professional		$517.96	$690.09	$969.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $421.51 / $581.00 / $692.31	Professional	54	$421.51	$581.00	$692.31
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $84.30 / $116.20 / $138.46	Professional	55	$84.30	$116.20	$138.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $591.46 / $591.46 / $1,181.51	Professional		$591.46	$591.46	$1,181.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,339.48 / $1,561.21 / $2,115.19	Facility		$1,339.48	$1,561.21	$2,115.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.03 / $850.13 / $1,409.42	Professional		$170.03	$850.13	$1,409.42
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,435.62 / $1,435.62 / $1,647.33	Professional	50	$1,435.62	$1,435.62	$1,647.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.98 / $622.00 / $1,086.68	Professional		$471.98	$622.00	$1,086.68
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $668.67 / $2,056.00 / $13,745.92	Facility		$668.67	$2,056.00	$13,745.92
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $581.00 / $581.00 / $667.58	Facility	54	$581.00	$581.00	$667.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $569.75 / $753.87 / $997.15	Professional		$569.75	$753.87	$997.15
Health Alliance Plan Facility/Professional Professional Modifier 54 Low / Median / High Price $516.32 / $602.52 / $692.31	Professional	54	$516.32	$602.52	$692.31
Health Alliance Plan Facility/Professional Professional Modifier 55 Low / Median / High Price $103.26 / $120.50 / $138.46	Professional	55	$103.26	$120.50	$138.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.99 / $450.93 / $783.73	Professional		$67.99	$450.93	$783.73
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $3,569.00 / $6,740.00	Facility		$1,050.00	$3,569.00	$6,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $665.66 / $782.73 / $1,085.30	Professional		$665.66	$782.73	$1,085.30