Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $257.04 / $3,162.28	Facility		$58.88	$257.04	$3,162.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility	50	$3,311.31	$3,311.31	$3,311.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $66.07 / $162.18	Professional		$34.67	$66.07	$162.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $134.90 / $331.13	Professional	50	$61.66	$134.90	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $50.12 / $67.61	Professional		$26.92	$50.12	$67.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $75.86 / $109.65	Professional	50	$36.31	$75.86	$109.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $63.10 / $63.10	Facility		$7.59	$63.10	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $67.61	Professional		$41.69	$57.54	$67.61
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $91.20 / $102.33	Professional	50	$67.61	$91.20	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $52.48 / $74.13	Facility		$40.74	$52.48	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $117.49	Professional		$50.12	$69.18	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $95.50	Professional		$34.67	$51.29	$95.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $288.40 / $3,162.28	Facility		$58.88	$288.40	$3,162.28
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility	50	$3,311.31	$3,311.31	$3,311.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $125.89	Professional		$38.02	$64.57	$125.89
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $134.90 / $331.13	Professional	50	$61.66	$134.90	$331.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $83.18	Professional		$33.11	$46.77	$83.18
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 $37.15 / $51.29 / $70.79	Professional		$37.15	$51.29	$70.79