Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.74 / $273.20 / $3,602.15	Facility		$97.74	$273.20	$3,602.15
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $41.50 / $43.10 / $121.66	Facility	52	$41.50	$43.10	$121.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $185.02 / $317.61	Professional		$66.51	$185.02	$317.61
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.71 / $71.33 / $121.66	Professional	52	$31.71	$71.33	$121.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.06 / $157.99 / $157.99	Professional		$56.06	$157.99	$157.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.44 / $149.94 / $204.26	Facility		$128.44	$149.94	$204.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $61.58 / $84.30	Professional		$11.53	$61.58	$84.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.67 / $81.90 / $90.11	Facility		$60.67	$81.90	$90.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $178.72 / $212.76 / $223.85	Professional		$178.72	$212.76	$223.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $130.72 / $274.13	Professional		$65.20	$130.72	$274.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $98.65 / $261.74 / $2,877.00	Facility		$98.65	$261.74	$2,877.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $41.50 / $41.50 / $117.15	Facility	52	$41.50	$41.50	$117.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $192.51 / $341.74	Professional		$75.06	$192.51	$341.74
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $39.02 / $81.70 / $121.66	Professional	52	$39.02	$81.70	$121.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.01 / $170.07 / $243.46	Professional		$136.01	$170.07	$243.46
United Facility/Professional Facility Modifier Low / Median / High Price $152.18 / $1,386.00 / $2,029.00	Facility		$152.18	$1,386.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $188.50 / $237.32 / $328.32	Professional		$188.50	$237.32	$328.32