Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.43 / $324.62 / $6,906.00	Facility		$166.43	$324.62	$6,906.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,705.98 / $7,001.48 / $9,420.84	Facility	50	$6,705.98	$7,001.48	$9,420.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.32 / $338.24 / $739.53	Professional	50	$148.32	$338.24	$739.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $170.76 / $170.76 / $265.68	Professional	50	$170.76	$170.76	$265.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,186.32 / $2,587.92 / $5,817.16	Facility		$1,186.32	$2,587.92	$5,817.16
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $790.09 / $1,724.94 / $2,429.32	Facility	50	$790.09	$1,724.94	$2,429.32
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $384.54 / $384.54 / $384.54	Professional	50	$384.54	$384.54	$384.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.46 / $135.24 / $178.34	Facility		$111.46	$135.24	$178.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.09 / $205.09 / $205.09	Facility		$205.09	$205.09	$205.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $166.43 / $409.03 / $6,906.00	Facility		$166.43	$409.03	$6,906.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,851.54 / $7,001.48 / $9,420.84	Facility	50	$3,851.54	$7,001.48	$9,420.84
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $148.32 / $557.07 / $739.53	Professional	50	$148.32	$557.07	$739.53
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,438.00 / $2,029.00	Facility		$464.00	$1,438.00	$2,029.00