Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $505.51 / $4,112.00 / $16,447.68	Facility		$505.51	$4,112.00	$16,447.68
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,656.83 / $9,409.09 / $22,802.36	Facility	50	$4,656.83	$9,409.09	$22,802.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $294.57 / $542.38 / $2,615.94	Professional		$294.57	$542.38	$2,615.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $156.31 / $321.35 / $1,323.63	Professional	50	$156.31	$321.35	$1,323.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.73 / $243.92 / $397.98	Professional		$172.73	$243.92	$397.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $221.14 / $365.88 / $686.00	Professional	50	$221.14	$365.88	$686.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,376.89 / $24,112.54 / $59,248.41	Facility		$11,376.89	$24,112.54	$59,248.41
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $7,618.42 / $11,360.12 / $24,224.12	Facility	50	$7,618.42	$11,360.12	$24,224.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $573.08 / $982.43	Professional		$103.70	$573.08	$982.43
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $875.60 / $875.60 / $875.60	Professional	50	$875.60	$875.60	$875.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $337.99 / $410.51 / $540.78	Facility		$337.99	$410.51	$540.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,742.83 / $2,265.67 / $2,896.07	Professional		$1,742.83	$2,265.67	$2,896.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.90 / $621.90 / $621.90	Facility		$621.90	$621.90	$621.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.21 / $1,509.27 / $4,008.05	Professional		$370.21	$1,509.27	$4,008.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $514.61 / $5,185.64 / $16,447.68	Facility		$514.61	$5,185.64	$16,447.68
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,958.00 / $10,936.79 / $22,802.36	Facility	50	$1,958.00	$10,936.79	$22,802.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $294.57 / $1,709.61 / $2,746.73	Professional		$294.57	$1,709.61	$2,746.73
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $234.47 / $575.58 / $1,323.63	Professional	50	$234.47	$575.58	$1,323.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,554.54 / $1,944.58 / $2,745.16	Professional		$1,554.54	$1,944.58	$2,745.16
United Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $10,192.00 / $12,767.00	Facility		$5,000.00	$10,192.00	$12,767.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,005.34 / $2,388.91 / $3,568.35	Professional		$2,005.34	$2,388.91	$3,568.35