Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.56 / $472.78 / $1,763.51	Facility		$84.56	$472.78	$1,763.51
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $314.20 / $421.03 / $1,409.62	Facility	50	$314.20	$421.03	$1,409.62
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.88 / $29.99 / $42.28	Facility	52	$28.88	$29.99	$42.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $74.04 / $199.35	Professional		$45.48	$74.04	$199.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $84.18 / $126.84 / $282.07	Professional	50	$84.18	$126.84	$282.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $63.30 / $98.57	Professional		$43.45	$63.30	$98.57
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.33 / $99.03 / $147.85	Professional	50	$70.33	$99.03	$147.85
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 $211.89 / $338.71 / $407.18	Facility	50	$211.89	$338.71	$407.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.63 / $53.41 / $85.72	Professional		$8.63	$53.41	$85.72
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.83 / $85.68 / $123.48	Professional	50	$72.83	$85.68	$123.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.86 / $55.72 / $103.06	Facility		$42.86	$55.72	$103.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $79.47 / $123.93	Professional		$58.90	$79.47	$123.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.61 / $63.03 / $115.69	Professional		$45.61	$63.03	$115.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.43 / $458.24 / $1,687.61	Facility		$81.43	$458.24	$1,687.61
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $355.47 / $668.80 / $2,367.15	Facility	50	$355.47	$668.80	$2,367.15
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $28.88 / $28.88 / $40.72	Facility	52	$28.88	$28.88	$40.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.60 / $76.23 / $154.80	Professional		$52.60	$76.23	$154.80
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $84.18 / $133.19 / $328.00	Professional	50	$84.18	$133.19	$328.00
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 $61.24 / $81.02 / $110.91	Professional		$61.24	$81.02	$110.91
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $85.00	Professional	50	$80.00	$80.00	$85.00