Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $162.18 / $436.52	Facility		$36.31	$162.18	$436.52
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $239.88 / $316.23 / $316.23	Facility	50	$239.88	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $53.70 / $109.65	Professional		$25.12	$53.70	$109.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $87.10 / $213.80	Professional	50	$69.18	$87.10	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $63.10	Professional		$50.12	$57.54	$63.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $89.13 / $93.33	Professional	50	$75.86	$89.13	$93.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $30.90 / $30.90	Facility		$17.78	$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 $25.70 / $42.66 / $79.43	Professional		$25.70	$42.66	$79.43
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $120.23 / $120.23	Professional	50	$48.98	$120.23	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $38.02 / $54.95	Facility		$29.51	$38.02	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $134.90	Professional		$57.54	$77.62	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $50.12 / $107.15	Professional		$26.30	$50.12	$107.15
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $154.88 / $436.52	Facility		$44.67	$154.88	$436.52
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $239.88 / $316.23 / $316.23	Facility	50	$239.88	$316.23	$316.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $60.26 / $97.72	Professional		$30.90	$60.26	$97.72
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $95.50 / $186.21	Professional	50	$81.28	$95.50	$186.21
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $45.71 / $107.15	Professional		$24.55	$45.71	$107.15
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 $30.20 / $52.48 / $77.62	Professional		$30.20	$52.48	$77.62