Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.04 / $255.44 / $2,077.21	Facility		$47.04	$255.44	$2,077.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $54.37 / $122.08	Professional		$34.77	$54.37	$122.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.27 / $100.54 / $140.05	Professional	50	$50.27	$100.54	$140.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.92 / $50.32 / $70.09	Professional		$30.92	$50.32	$70.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.47 / $80.88 / $114.48	Professional	50	$75.47	$80.88	$114.48
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 Facility Modifier 50 Low / Median / High Price $248.19 / $289.12 / $406.58	Facility	50	$248.19	$289.12	$406.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.23 / $38.04 / $68.04	Professional		$7.23	$38.04	$68.04
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.30 / $67.41 / $102.06	Professional	50	$57.30	$67.41	$102.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.75 / $42.50 / $51.00	Facility		$33.75	$42.50	$51.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.85 / $65.42 / $101.62	Professional		$48.85	$65.42	$101.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $51.59 / $94.61	Professional		$35.89	$51.59	$94.61
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $53.80 / $417.99 / $2,816.10	Facility		$53.80	$417.99	$2,816.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $58.02 / $99.48	Professional		$44.47	$58.02	$99.48
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $50.27 / $106.32 / $140.05	Professional	50	$50.27	$106.32	$140.05
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 $48.84 / $62.36 / $80.72	Professional		$48.84	$62.36	$80.72