Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.15 / $384.20 / $4,933.00	Facility		$52.15	$384.20	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $58.25 / $107.36	Professional		$38.61	$58.25	$107.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.20 / $73.20 / $95.65	Professional	50	$73.20	$73.20	$95.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $57.48 / $96.32	Professional		$28.74	$57.48	$96.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.68 / $460.89 / $624.42	Facility		$392.68	$460.89	$624.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.68 / $41.65 / $71.13	Professional		$7.68	$41.65	$71.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.36 / $45.79 / $54.95	Facility		$36.36	$45.79	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.36 / $69.97 / $108.77	Professional		$52.36	$69.97	$108.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $58.24 / $103.64	Professional		$38.45	$58.24	$103.64
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $58.30 / $384.20 / $4,933.00	Facility		$58.30	$384.20	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $62.67 / $102.15	Professional		$49.72	$62.67	$102.15
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $73.20 / $95.65 / $95.65	Professional	50	$73.20	$95.65	$95.65
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 $215.18 / $1,155.00 / $1,844.00	Facility		$215.18	$1,155.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $69.29 / $97.56	Professional		$58.30	$69.29	$97.56