Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $878.66 / $4,933.00 / $5,757.00	Facility		$878.66	$4,933.00	$5,757.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $175.73 / $175.73 / $182.24	Facility	53	$175.73	$175.73	$182.24
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $659.00 / $659.00 / $683.40	Facility	54	$659.00	$659.00	$683.40
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $131.80 / $131.80 / $136.68	Facility	55	$131.80	$131.80	$136.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $570.54 / $675.56 / $1,113.95	Professional		$570.54	$675.56	$1,113.95
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.58 / $131.80 / $136.68	Professional	55	$95.58	$131.80	$136.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $669.33 / $669.33 / $1,158.77	Professional		$669.33	$669.33	$1,158.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,939.32 / $8,088.02 / $10,957.98	Facility		$6,939.32	$8,088.02	$10,957.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.85 / $600.23 / $1,124.43	Professional		$171.85	$600.23	$1,124.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.24 / $760.28 / $1,342.63	Professional		$535.24	$760.28	$1,342.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $669.21 / $4,933.00 / $5,757.00	Facility		$669.21	$4,933.00	$5,757.00
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $175.73 / $175.73 / $175.73	Facility	53	$175.73	$175.73	$175.73
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $659.00 / $659.00 / $659.00	Facility	54	$659.00	$659.00	$659.00
Health Alliance Plan Facility/Professional Facility Modifier 55 Low / Median / High Price $131.80 / $131.80 / $131.80	Facility	55	$131.80	$131.80	$131.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $609.66 / $716.81 / $911.20	Professional		$609.66	$716.81	$911.20
Health Alliance Plan Facility/Professional Professional Modifier 55 Low / Median / High Price $105.51 / $131.80 / $136.68	Professional	55	$105.51	$131.80	$136.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $434.51 / $730.73	Professional		$68.25	$434.51	$730.73
United Facility/Professional Facility Modifier Low / Median / High Price $3,986.00 / $7,519.00 / $10,652.00	Facility		$3,986.00	$7,519.00	$10,652.00
United Facility/Professional Professional Modifier Low / Median / High Price $715.67 / $859.84 / $1,122.34	Professional		$715.67	$859.84	$1,122.34