Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,328.35 / $21,881.77 / $33,631.42	Facility		$1,328.35	$21,881.77	$33,631.42
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $253.02 / $253.02 / $253.02	Facility	53	$253.02	$253.02	$253.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $949.61 / $1,102.35 / $1,795.41	Professional		$949.61	$1,102.35	$1,795.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $983.65 / $983.65 / $983.65	Professional		$983.65	$983.65	$983.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $557.04 / $1,109.83 / $2,021.37	Facility		$557.04	$1,109.83	$2,021.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,311.39 / $1,435.63 / $1,863.55	Professional		$1,311.39	$1,435.63	$1,863.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $880.82 / $1,189.10 / $1,308.24	Facility		$880.82	$1,189.10	$1,308.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $856.53 / $856.53 / $1,019.68	Professional		$856.53	$856.53	$1,019.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $839.38 / $1,512.51 / $1,961.69	Professional		$839.38	$1,512.51	$1,961.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,265.09 / $18,239.50 / $33,631.42	Facility		$1,265.09	$18,239.50	$33,631.42
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $253.02 / $253.02 / $253.02	Facility	53	$253.02	$253.02	$253.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $958.06 / $1,265.08 / $1,862.69	Professional		$958.06	$1,265.08	$1,862.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $771.74 / $974.34 / $1,456.93	Professional		$771.74	$974.34	$1,456.93
United Facility/Professional Facility Modifier Low / Median / High Price $8,301.00 / $12,733.00 / $22,993.00	Facility		$8,301.00	$12,733.00	$22,993.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,170.59 / $1,550.29 / $2,204.36	Professional		$1,170.59	$1,550.29	$2,204.36