Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $131.83 / $4,897.79	Facility		$67.61	$131.83	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $158.49 / $162.18 / $724.44	Facility	50	$158.49	$162.18	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $223.87	Professional		$54.95	$97.72	$223.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $131.83 / $194.98 / $575.44	Professional	50	$131.83	$194.98	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $123.03	Professional		$64.57	$83.18	$123.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $154.88 / $169.82	Professional	50	$107.15	$154.88	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $91.20	Facility		$67.61	$67.61	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $87.10 / $104.71	Professional		$61.66	$87.10	$104.71
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $134.90 / $158.49	Professional	50	$107.15	$134.90	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $81.28 / $120.23	Facility		$64.57	$81.28	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $181.97	Professional		$77.62	$104.71	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $79.43 / $147.91	Professional		$53.70	$79.43	$147.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $186.21 / $4,897.79	Facility		$72.44	$186.21	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $158.49 / $162.18 / $724.44	Facility	50	$158.49	$162.18	$724.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $169.82	Professional		$61.66	$95.50	$169.82
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $186.21 / $467.74	Professional	50	$123.03	$186.21	$467.74
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $74.13 / $131.83	Professional		$46.77	$74.13	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $870.96 / $1,737.80	Facility		$229.09	$870.96	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $107.15	Professional		$58.88	$79.43	$107.15