Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.49 / $290.04 / $4,933.00	Facility		$170.49	$290.04	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $196.21 / $290.04	Professional		$121.34	$196.21	$290.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $209.18 / $369.00	Professional		$65.20	$209.18	$369.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $256.61 / $297.83 / $403.52	Facility		$256.61	$297.83	$403.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $196.20 / $341.40	Professional		$35.02	$196.20	$341.40
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $314.76 / $314.76 / $512.10	Professional	50	$314.76	$314.76	$512.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.27 / $190.05 / $401.42	Professional		$116.27	$190.05	$401.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $170.49 / $279.68 / $4,933.00	Facility		$170.49	$279.68	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $158.26 / $212.55 / $337.32	Professional		$158.26	$212.55	$337.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $205.20 / $283.67	Professional		$152.97	$205.20	$283.67
United Facility/Professional Facility Modifier Low / Median / High Price $1,006.00 / $3,362.00 / $6,327.00	Facility		$1,006.00	$3,362.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $216.58 / $249.58 / $340.21	Professional		$216.58	$249.58	$340.21