Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.09 / $464.00 / $4,933.00	Facility		$187.09	$464.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.15 / $187.09 / $293.00	Professional		$128.15	$187.09	$293.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $194.52 / $249.42 / $273.29	Professional	50	$194.52	$249.42	$273.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.37 / $194.73 / $210.24	Professional		$97.37	$194.73	$210.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $232.16 / $270.58 / $366.61	Facility		$232.16	$270.58	$366.61
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $132.78 / $190.96 / $248.57	Facility	50	$132.78	$190.96	$248.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $151.29 / $343.53	Professional		$37.00	$151.29	$343.53
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $349.13 / $349.13 / $515.29	Professional	50	$349.13	$349.13	$515.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.58 / $181.55 / $347.29	Professional		$121.58	$181.55	$347.29
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $201.99 / $2,056.00 / $4,933.00	Facility		$201.99	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $160.27 / $201.99 / $293.00	Professional		$160.27	$201.99	$293.00
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $194.52 / $194.52 / $273.29	Professional	50	$194.52	$194.52	$273.29
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 $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 $205.25 / $244.21 / $327.56	Professional		$205.25	$244.21	$327.56