Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.44 / $125.55 / $293.77	Facility		$53.44	$125.55	$293.77
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $173.96 / $440.85 / $541.51	Facility	50	$173.96	$440.85	$541.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.52 / $67.65 / $169.57	Professional		$39.52	$67.65	$169.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.57 / $114.57 / $114.57	Professional	50	$114.57	$114.57	$114.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $68.51 / $89.06	Professional		$41.40	$68.51	$89.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.46 / $149.40 / $339.81	Facility		$104.46	$149.40	$339.81
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $86.90 / $102.44 / $131.69	Facility	50	$86.90	$102.44	$131.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.94 / $64.31 / $102.20	Professional		$10.94	$64.31	$102.20
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $83.53 / $98.27 / $166.17	Professional	50	$83.53	$98.27	$166.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.75 / $47.50 / $56.63	Facility		$37.75	$47.50	$56.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.16 / $82.43 / $103.84	Professional		$62.16	$82.43	$103.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $64.47 / $116.26	Professional		$41.57	$64.47	$116.26
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.17 / $160.30 / $370.00	Facility		$54.17	$160.30	$370.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $212.65 / $440.85 / $541.51	Facility	50	$212.65	$440.85	$541.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $74.34 / $118.32	Professional		$51.25	$74.34	$118.32
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $114.57 / $114.57 / $565.33	Professional	50	$114.57	$114.57	$565.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $101.78 / $144.21	Professional		$81.79	$101.78	$144.21
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 $50.08 / $74.31 / $102.88	Professional		$50.08	$74.31	$102.88