Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.21 / $49.71 / $4,933.00	Facility		$25.21	$49.71	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $589.67 / $589.67 / $589.67	Facility	50	$589.67	$589.67	$589.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $39.78 / $63.68	Professional		$19.39	$39.78	$63.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.55 / $28.28 / $60.44	Professional	50	$14.55	$28.28	$60.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.26 / $17.59 / $32.00	Professional		$9.26	$17.59	$32.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $27.77 / $27.77 / $27.77	Professional	50	$27.77	$27.77	$27.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.91 / $168.90 / $228.84	Facility		$144.91	$168.90	$228.84
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $82.88 / $119.38 / $155.16	Facility	50	$82.88	$119.38	$155.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.69 / $24.62 / $38.88	Professional		$4.69	$24.62	$38.88
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.28 / $41.58 / $41.58	Professional	50	$35.28	$41.58	$41.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.03 / $41.04 / $64.45	Professional		$18.03	$41.04	$64.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.54 / $51.53 / $4,933.00	Facility		$28.54	$51.53	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $526.50 / $526.50 / $589.67	Facility	50	$526.50	$526.50	$589.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $20.30 / $33.27 / $70.36	Professional		$20.30	$33.27	$70.36
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $14.55 / $32.96 / $67.09	Professional	50	$14.55	$32.96	$67.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.93 / $14.06 / $75.00	Professional		$11.93	$14.06	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,386.00 / $2,449.00	Facility		$300.00	$1,386.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $54.81 / $72.02	Professional		$22.93	$54.81	$72.02