Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,633.30 / $6,366.13 / $13,199.67	Facility		$1,633.30	$6,366.13	$13,199.67
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,499.65 / $23,175.65 / $23,175.65	Facility	50	$6,499.65	$23,175.65	$23,175.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $523.82 / $697.92 / $1,288.61	Professional		$523.82	$697.92	$1,288.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $320.04 / $703.19 / $1,152.14	Professional		$320.04	$703.19	$1,152.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,106.14 / $5,960.41 / $8,119.72	Facility		$5,106.14	$5,960.41	$8,119.72
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,755.26 / $4,059.86 / $5,505.38	Facility	50	$2,755.26	$4,059.86	$5,505.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.33 / $1,046.28 / $1,569.42	Professional		$186.33	$1,046.28	$1,569.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $628.72 / $848.77 / $933.82	Facility		$628.72	$848.77	$933.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.19 / $733.56 / $832.10	Professional		$616.19	$733.56	$832.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.23 / $826.78 / $1,330.14	Professional		$436.23	$826.78	$1,330.14
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,899.27 / $7,351.01 / $17,506.62	Facility		$1,899.27	$7,351.01	$17,506.62
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $6,499.65 / $23,175.65 / $23,175.65	Facility	50	$6,499.65	$23,175.65	$23,175.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $610.41 / $786.42 / $1,474.94	Professional		$610.41	$786.42	$1,474.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.66 / $462.04 / $769.19	Professional		$68.66	$462.04	$769.19
United Facility/Professional Facility Modifier Low / Median / High Price $2,524.00 / $5,819.00 / $8,339.00	Facility		$2,524.00	$5,819.00	$8,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $653.48 / $816.01 / $1,079.85	Professional		$653.48	$816.01	$1,079.85