Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.97 / $620.00 / $4,933.00	Facility		$141.97	$620.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.31 / $120.43 / $162.37	Professional		$90.31	$120.43	$162.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $207.18 / $207.18 / $207.18	Professional		$207.18	$207.18	$207.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $177.90 / $177.90 / $177.91	Professional	50	$177.90	$177.90	$177.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $134.13 / $180.84	Facility		$115.00	$134.13	$180.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $108.72 / $245.01	Professional		$27.77	$108.72	$245.01
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $262.04 / $262.04 / $289.20	Professional	50	$262.04	$262.04	$289.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.13 / $114.32 / $237.47	Professional		$85.13	$114.32	$237.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $118.92 / $2,877.00 / $4,933.00	Facility		$118.92	$2,877.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $103.14 / $132.55 / $202.88	Professional		$103.14	$132.55	$202.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.37 / $101.38 / $139.66	Professional		$82.37	$101.38	$139.66
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 $120.83 / $143.21 / $198.10	Professional		$120.83	$143.21	$198.10