Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.15 / $118.43 / $4,933.00	Facility		$15.15	$118.43	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $64.27 / $119.59	Professional		$15.15	$64.27	$119.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.76 / $95.76 / $95.76	Professional		$95.76	$95.76	$95.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $477.80 / $652.65 / $1,503.92	Facility		$477.80	$652.65	$1,503.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.64 / $19.47 / $23.82	Professional		$3.64	$19.47	$23.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $88.09 / $119.25	Professional		$19.05	$88.09	$119.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $15.57 / $93.37 / $4,933.00	Facility		$15.57	$93.37	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $15.30 / $93.37 / $136.19	Professional		$15.30	$93.37	$136.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.29 / $100.63 / $142.08	Professional		$81.29	$100.63	$142.08
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $88.38 / $109.72 / $147.74	Professional		$88.38	$109.72	$147.74