Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $60.26 / $69.18	Facility		$23.44	$60.26	$69.18
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $123.03 / $123.03 / $138.04	Facility	50	$123.03	$123.03	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $28.18 / $61.66	Professional		$15.85	$28.18	$61.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $85.11 / $117.49	Professional	50	$47.86	$85.11	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.12 / $33.88	Professional		$21.88	$25.12	$33.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $30.90 / $30.90	Facility		$19.05	$30.90	$30.90
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	50	$144.54	$144.54	$144.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $35.48	Professional		$21.88	$28.84	$35.48
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $33.11 / $53.70	Professional	50	$33.11	$33.11	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $25.70 / $37.15	Facility		$19.95	$25.70	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $61.66	Professional		$26.30	$36.31	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $28.84 / $50.12	Professional		$17.38	$28.84	$50.12
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $61.66 / $95.50	Facility		$23.44	$61.66	$95.50
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $123.03 / $123.03 / $138.04	Facility	50	$123.03	$123.03	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $32.36 / $54.95	Professional		$19.05	$32.36	$54.95
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $74.13 / $117.49	Professional	50	$47.86	$74.13	$117.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $26.92 / $47.86	Professional		$16.22	$26.92	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $794.33 / $1,737.80	Facility		$123.03	$794.33	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.11 / $48.98	Professional		$19.05	$33.11	$48.98