Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.43 / $143.37 / $508.16	Facility		$35.43	$143.37	$508.16
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $165.00 / $543.29 / $863.52	Facility	50	$165.00	$543.29	$863.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $64.45 / $113.79	Professional		$27.10	$64.45	$113.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.08 / $137.72 / $137.72	Professional	50	$43.08	$137.72	$137.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $71.23 / $83.81	Professional		$25.76	$71.23	$83.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.86 / $228.28 / $520.02	Facility		$159.86	$228.28	$520.02
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $106.39 / $163.32 / $204.45	Facility	50	$106.39	$163.32	$204.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.69 / $42.08 / $67.87	Professional		$6.69	$42.08	$67.87
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $53.65 / $177.24 / $208.52	Professional	50	$53.65	$177.24	$208.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.93 / $31.31 / $37.29	Facility		$24.93	$31.31	$37.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $102.34 / $129.58	Professional		$78.68	$102.34	$129.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.93 / $63.00 / $132.76	Professional		$18.93	$63.00	$132.76
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $35.43 / $137.94 / $517.69	Facility		$35.43	$137.94	$517.69
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $219.24 / $543.29 / $863.52	Facility	50	$219.24	$543.29	$863.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.87 / $78.23 / $122.83	Professional		$31.87	$78.23	$122.83
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $43.08 / $137.72 / $137.72	Professional	50	$43.08	$137.72	$137.72
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 $125.00 / $1,155.00 / $1,844.00	Facility		$125.00	$1,155.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $103.01 / $127.08	Professional		$69.23	$103.01	$127.08