Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.88 / $762.85 / $4,933.00	Facility		$88.88	$762.85	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.98 / $82.14 / $109.89	Professional		$60.98	$82.14	$109.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.16 / $64.16 / $75.34	Professional		$64.16	$64.16	$75.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.16 / $92.34 / $129.91	Facility		$79.16	$92.34	$129.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $67.65 / $154.63	Professional		$17.52	$67.65	$154.63
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.38 / $165.38 / $195.74	Professional	50	$165.38	$165.38	$195.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.51 / $75.98 / $124.46	Professional		$54.51	$75.98	$124.46
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $80.93 / $821.34 / $4,933.00	Facility		$80.93	$821.34	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.15 / $88.88 / $133.63	Professional		$67.15	$88.88	$133.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.45 / $67.94 / $92.00	Professional		$55.45	$67.94	$92.00
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 $81.95 / $92.49 / $123.19	Professional		$81.95	$92.49	$123.19