Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.50 / $2,371.32 / $4,084.99	Facility		$409.50	$2,371.32	$4,084.99
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,740.00 / $3,689.95 / $29,970.84	Facility	50	$2,740.00	$3,689.95	$29,970.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.77 / $878.70 / $2,276.94	Professional		$304.77	$878.70	$2,276.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $607.44 / $698.45 / $1,333.46	Professional	50	$607.44	$698.45	$1,333.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.28 / $339.04 / $1,218.92	Professional		$152.28	$339.04	$1,218.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $204.67 / $204.67 / $204.67	Professional	50	$204.67	$204.67	$204.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,967.94 / $8,192.01 / $19,706.36	Facility		$5,967.94	$8,192.01	$19,706.36
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,197.86 / $4,846.47 / $5,890.04	Facility	50	$3,197.86	$4,846.47	$5,890.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $433.74 / $723.67	Professional		$77.42	$433.74	$723.67
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $695.84 / $695.84 / $3,234.75	Professional	50	$695.84	$695.84	$3,234.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $272.27 / $333.55 / $427.35	Facility		$272.27	$333.55	$427.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,208.80 / $1,571.44 / $2,000.09	Professional		$1,208.80	$1,571.44	$2,000.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.98 / $500.98 / $500.98	Facility		$500.98	$500.98	$500.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.76 / $974.64 / $2,896.83	Professional		$313.76	$974.64	$2,896.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $37.88 / $1,915.87 / $4,933.00	Facility		$37.88	$1,915.87	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,740.00 / $13,169.52 / $29,970.84	Facility	50	$2,740.00	$13,169.52	$29,970.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $316.07 / $1,716.63 / $2,336.85	Professional		$316.07	$1,716.63	$2,336.85
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $607.44 / $698.45 / $698.45	Professional	50	$607.44	$698.45	$698.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,056.06 / $1,321.34 / $1,863.64	Professional		$1,056.06	$1,321.34	$1,863.64
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
United Facility/Professional Professional Modifier Low / Median / High Price $1,482.14 / $2,150.15 / $3,045.11	Professional		$1,482.14	$2,150.15	$3,045.11