Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $314.83 / $501.26 / $4,933.00	Facility		$314.83	$501.26	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $227.70 / $236.13 / $298.37	Facility	54	$227.70	$236.13	$298.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.42 / $303.60 / $501.52	Professional		$233.42	$303.60	$501.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $442.29 / $442.29 / $442.29	Professional	50	$442.29	$442.29	$442.29
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $167.55 / $227.70 / $298.37	Professional	54	$167.55	$227.70	$298.37
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.51 / $45.54 / $59.67	Professional	55	$33.51	$45.54	$59.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.08 / $288.08 / $509.56	Professional		$288.08	$288.08	$509.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $603.71 / $703.65 / $953.33	Facility		$603.71	$703.65	$953.33
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $323.49 / $497.32 / $646.39	Facility	50	$323.49	$497.32	$646.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.18 / $241.99 / $496.03	Professional		$59.18	$241.99	$496.03
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $558.44 / $558.44 / $703.83	Professional	50	$558.44	$558.44	$703.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.49 / $320.98 / $469.22	Professional		$193.49	$320.98	$469.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $308.17 / $1,024.92 / $4,933.00	Facility		$308.17	$1,024.92	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $227.70 / $227.70 / $287.72	Facility	54	$227.70	$227.70	$287.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $261.94 / $321.32 / $502.44	Professional		$261.94	$321.32	$502.44
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $442.29 / $442.29 / $442.29	Professional	50	$442.29	$442.29	$442.29
Health Alliance Plan Facility/Professional Professional Modifier 54 Low / Median / High Price $220.91 / $236.61 / $298.37	Professional	54	$220.91	$236.61	$298.37
Health Alliance Plan Facility/Professional Professional Modifier 55 Low / Median / High Price $44.18 / $47.32 / $59.67	Professional	55	$44.18	$47.32	$59.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.24 / $237.55 / $348.68	Professional		$32.24	$237.55	$348.68
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $2,800.00 / $4,594.00	Facility		$645.00	$2,800.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $320.74 / $388.61 / $526.15	Professional		$320.74	$388.61	$526.15