Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $505.70 / $4,933.00 / $11,925.56	Facility		$505.70	$4,933.00	$11,925.56
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,807.31 / $4,807.31 / $7,498.72	Facility	50	$4,807.31	$4,807.31	$7,498.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.42 / $486.97 / $858.26	Professional		$299.42	$486.97	$858.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.10 / $396.19 / $535.25	Professional		$198.10	$396.19	$535.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,179.54 / $4,905.56 / $6,646.25	Facility		$4,179.54	$4,905.56	$6,646.25
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,407.02 / $3,077.32 / $4,506.33	Facility	50	$2,407.02	$3,077.32	$4,506.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.49 / $457.61 / $1,052.86	Professional		$110.49	$457.61	$1,052.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $365.47 / $460.78 / $548.21	Facility		$365.47	$460.78	$548.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $490.03 / $649.77 / $818.68	Professional		$490.03	$649.77	$818.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.70 / $515.60 / $958.59	Professional		$366.70	$515.60	$958.59
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $505.69 / $3,916.00 / $9,628.04	Facility		$505.69	$3,916.00	$9,628.04
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $4,807.31 / $4,807.31 / $7,498.72	Facility	50	$4,807.31	$4,807.31	$7,498.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $374.75 / $535.66 / $882.24	Professional		$374.75	$535.66	$882.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $349.51 / $618.14	Professional		$68.34	$349.51	$618.14
United Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $5,806.00 / $8,339.00	Facility		$1,450.00	$5,806.00	$8,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $474.87 / $601.90 / $870.90	Professional		$474.87	$601.90	$870.90