Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.36 / $214.67 / $4,933.00	Facility		$162.36	$214.67	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.84 / $197.71 / $262.37	Professional		$149.84	$197.71	$262.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $324.68 / $324.68 / $324.68	Professional	50	$324.68	$324.68	$324.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $170.21 / $274.94	Professional		$156.38	$170.21	$274.94
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $297.95 / $297.95 / $412.41	Professional	50	$297.95	$297.95	$412.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.37 / $376.89 / $510.63	Facility		$323.37	$376.89	$510.63
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $184.93 / $236.43 / $346.22	Facility	50	$184.93	$236.43	$346.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $133.90 / $236.89	Professional		$25.57	$133.90	$236.89
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $241.29 / $241.29 / $301.14	Professional	50	$241.29	$241.29	$301.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.77 / $187.82 / $277.05	Professional		$119.77	$187.82	$277.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $162.36 / $241.54 / $4,933.00	Facility		$162.36	$241.54	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $158.78 / $210.28 / $282.60	Professional		$158.78	$210.28	$282.60
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $324.68 / $324.68 / $324.68	Professional	50	$324.68	$324.68	$324.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $137.26 / $195.97	Professional		$93.27	$137.26	$195.97
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 $160.55 / $239.63 / $321.36	Professional		$160.55	$239.63	$321.36