Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.69 / $36.90 / $63.96	Facility		$22.69	$36.90	$63.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $124.26 / $124.26 / $138.47	Facility	50	$124.26	$124.26	$138.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.44 / $29.43 / $46.89	Professional		$20.44	$29.43	$46.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.35 / $68.11 / $91.95	Professional	50	$48.35	$68.11	$91.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $28.03 / $28.03	Professional		$26.42	$28.03	$28.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.05 / $42.05 / $42.05	Professional	50	$42.05	$42.05	$42.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $166.29 / $242.47 / $555.21	Facility		$166.29	$242.47	$555.21
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $113.59 / $188.81 / $226.97	Facility	50	$113.59	$188.81	$226.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.85 / $19.39 / $34.07	Professional		$3.85	$19.39	$34.07
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $27.85 / $32.76 / $53.55	Professional	50	$27.85	$32.76	$53.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.55 / $20.88 / $25.05	Facility		$16.55	$20.88	$25.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $34.35 / $43.29	Professional		$25.91	$34.35	$43.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $30.01 / $49.75	Professional		$17.25	$30.01	$49.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $29.68 / $46.49 / $63.96	Facility		$29.68	$46.49	$63.96
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $124.26 / $124.26 / $138.47	Facility	50	$124.26	$124.26	$138.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $35.53 / $47.92	Professional		$22.69	$35.53	$47.92
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $48.35 / $48.35 / $91.95	Professional	50	$48.35	$48.35	$91.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.08 / $18.11 / $75.00	Professional		$11.08	$18.11	$75.00
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 $29.98 / $42.30 / $51.57	Professional		$29.98	$42.30	$51.57