Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $352.86 / $3,848.00 / $12,849.68	Facility		$352.86	$3,848.00	$12,849.68
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $964.56 / $3,098.10 / $8,806.11	Facility	50	$964.56	$3,098.10	$8,806.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.62 / $309.88 / $449.34	Professional		$218.62	$309.88	$449.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $98.89 / $220.92 / $2,188.89	Professional	50	$98.89	$220.92	$2,188.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,413.29 / $6,318.95 / $8,608.14	Facility		$5,413.29	$6,318.95	$8,608.14
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,936.93 / $3,985.71 / $5,604.85	Facility	50	$2,936.93	$3,985.71	$5,604.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.81 / $375.16 / $616.04	Professional		$69.81	$375.16	$616.04
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $633.53 / $633.53 / $633.53	Professional	50	$633.53	$633.53	$633.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $249.80 / $337.23 / $371.02	Facility		$249.80	$337.23	$371.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $250.78 / $298.55 / $328.68	Professional		$250.78	$298.55	$328.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.59 / $355.25 / $540.72	Professional		$190.59	$355.25	$540.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $328.24 / $3,848.00 / $8,399.25	Facility		$328.24	$3,848.00	$8,399.25
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,300.55 / $3,180.85 / $8,455.70	Facility	50	$1,300.55	$3,180.85	$8,455.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $256.85 / $338.70 / $567.46	Professional		$256.85	$338.70	$567.46
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $197.78 / $273.61 / $2,188.89	Professional	50	$197.78	$273.61	$2,188.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $311.90 / $442.00	Professional		$246.15	$311.90	$442.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,400.00 / $5,819.00 / $8,339.00	Facility		$3,400.00	$5,819.00	$8,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $324.27 / $382.78 / $523.53	Professional		$324.27	$382.78	$523.53