Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.75 / $122.83 / $4,933.00	Facility		$100.75	$122.83	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $105.00 / $157.50	Professional		$85.07	$105.00	$157.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $103.32 / $103.32 / $168.47	Professional	50	$103.32	$103.32	$168.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.98 / $91.98 / $91.98	Professional		$91.98	$91.98	$91.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $129.59 / $129.59 / $137.96	Professional	50	$129.59	$129.59	$137.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $319.27 / $372.13 / $504.18	Facility		$319.27	$372.13	$504.18
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $182.59 / $263.02 / $341.84	Facility	50	$182.59	$263.02	$341.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $58.17 / $146.58	Professional		$14.04	$58.17	$146.58
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $149.31 / $149.31 / $178.92	Professional	50	$149.31	$149.31	$178.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $94.29 / $171.43	Professional		$68.56	$94.29	$171.43
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $100.75 / $122.83 / $4,933.00	Facility		$100.75	$122.83	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $93.23 / $122.82 / $160.49	Professional		$93.23	$122.82	$160.49
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $103.32 / $103.32 / $168.47	Professional	50	$103.32	$103.32	$168.47
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 $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 $97.81 / $129.87 / $206.37	Professional		$97.81	$129.87	$206.37