Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.38 / $387.52 / $2,683.88	Facility		$64.38	$387.52	$2,683.88
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $130.60 / $322.83 / $1,502.28	Facility	50	$130.60	$322.83	$1,502.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $70.33 / $164.72	Professional		$37.88	$70.33	$164.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.20 / $109.79 / $261.36	Professional	50	$73.20	$109.79	$261.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.10 / $54.58 / $94.16	Professional		$40.10	$54.58	$94.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $57.84 / $81.86 / $151.00	Professional	50	$57.84	$81.86	$151.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $395.43 / $533.96 / $1,253.93	Facility		$395.43	$533.96	$1,253.93
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $248.19 / $321.13 / $407.18	Facility	50	$248.19	$321.13	$407.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.81 / $42.14 / $74.43	Professional		$7.81	$42.14	$74.43
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $62.65 / $93.71 / $110.25	Professional	50	$62.65	$93.71	$110.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.03 / $46.86 / $56.24	Facility		$37.03	$46.86	$56.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.74 / $70.95 / $110.56	Professional		$52.74	$70.95	$110.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $57.25 / $102.38	Professional		$39.28	$57.25	$102.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $59.01 / $383.43 / $2,056.00	Facility		$59.01	$383.43	$2,056.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $130.60 / $1,502.28 / $1,502.28	Facility	50	$130.60	$1,502.28	$1,502.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $65.70 / $139.65	Professional		$48.09	$65.70	$139.65
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $83.79 / $111.08 / $261.36	Professional	50	$83.79	$111.08	$261.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $68.01 / $96.85	Professional		$54.68	$68.01	$96.85
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.09 / $67.56 / $93.59	Professional		$54.09	$67.56	$93.59