Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $661.93 / $2,277.50 / $5,364.60	Facility		$661.93	$2,277.50	$5,364.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,503.15 / $2,503.15 / $2,628.47	Facility	50	$2,503.15	$2,503.15	$2,628.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.55 / $409.93 / $725.31	Professional		$149.55	$409.93	$725.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.93 / $144.96 / $405.48	Professional		$130.93	$144.96	$405.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.83 / $1,371.38 / $1,868.19	Facility		$1,174.83	$1,371.38	$1,868.19
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $792.41 / $934.09 / $1,053.73	Facility	50	$792.41	$934.09	$1,053.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $234.61 / $456.83	Professional		$38.35	$234.61	$456.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.60 / $193.86 / $213.28	Facility		$143.60	$193.86	$213.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $454.69 / $541.29 / $566.54	Professional		$454.69	$541.29	$566.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.40 / $346.65 / $914.64	Professional		$165.40	$346.65	$914.64
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $604.42 / $2,470.04 / $5,364.60	Facility		$604.42	$2,470.04	$5,364.60
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,503.15 / $2,503.15 / $2,628.47	Facility	50	$2,503.15	$2,503.15	$2,628.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $181.12 / $575.64 / $854.34	Professional		$181.12	$575.64	$854.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $380.93 / $476.60 / $681.87	Professional		$380.93	$476.60	$681.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $681.23 / $802.42 / $1,125.73	Professional		$681.23	$802.42	$1,125.73