Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.97 / $1,659.33 / $4,933.00	Facility		$68.97	$1,659.33	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $1,064.01 / $1,786.75	Professional		$60.14	$1,064.01	$1,786.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,111.92 / $1,562.46 / $1,854.51	Professional		$1,111.92	$1,562.46	$1,854.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $938.07 / $1,093.35 / $1,481.32	Facility		$938.07	$1,093.35	$1,481.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $64.73 / $101.97	Professional		$10.45	$64.73	$101.97
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $103.86 / $103.86 / $3,007.07	Professional	50	$103.86	$103.86	$3,007.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $1,027.39 / $1,856.67	Professional		$46.57	$1,027.39	$1,856.67
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $1,659.33 / $4,933.00	Facility		$75.09	$1,659.33	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $1,304.93 / $1,806.82	Professional		$68.90	$1,304.93	$1,806.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,030.63 / $1,277.26 / $1,746.05	Professional		$1,030.63	$1,277.26	$1,746.05
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 $1,292.73 / $1,599.27 / $2,156.03	Professional		$1,292.73	$1,599.27	$2,156.03