Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.81 / $3,140.35 / $9,837.36	Facility		$266.81	$3,140.35	$9,837.36
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,573.16 / $6,145.30 / $6,145.30	Facility	50	$2,573.16	$6,145.30	$6,145.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.38 / $269.16 / $387.25	Professional		$165.38	$269.16	$387.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $404.99 / $546.32 / $652.14	Professional	50	$404.99	$546.32	$652.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,766.73 / $2,059.19 / $2,789.87	Facility		$1,766.73	$2,059.19	$2,789.87
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $951.85 / $1,394.94 / $1,891.61	Facility	50	$951.85	$1,394.94	$1,891.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $161.97 / $316.45	Professional		$34.10	$161.97	$316.45
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $304.29 / $349.93 / $501.48	Professional	50	$304.29	$349.93	$501.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.35 / $204.32 / $224.80	Facility		$151.35	$204.32	$224.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $250.36 / $298.05 / $318.95	Professional		$250.36	$298.05	$318.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.99 / $248.95 / $400.44	Professional		$161.99	$248.95	$400.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $329.63 / $3,072.65 / $7,756.19	Facility		$329.63	$3,072.65	$7,756.19
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $238.21 / $5,231.30 / $6,145.30	Facility	50	$238.21	$5,231.30	$6,145.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $203.90 / $322.70 / $449.71	Professional		$203.90	$322.70	$449.71
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $546.32 / $643.50 / $870.00	Professional	50	$546.32	$643.50	$870.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.54 / $272.95 / $390.71	Professional		$219.54	$272.95	$390.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $285.81 / $348.30 / $500.00	Professional		$285.81	$348.30	$500.00