Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.42 / $2,056.00 / $4,933.00	Facility		$59.42	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.88 / $11.88 / $12.32	Facility	53	$11.88	$11.88	$12.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.60 / $59.42 / $262.00	Professional		$43.60	$59.42	$262.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.80 / $43.59 / $83.14	Professional		$21.80	$43.59	$83.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $704.46 / $962.93 / $2,220.60	Facility		$704.46	$962.93	$2,220.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.85 / $54.20 / $68.70	Professional		$12.85	$54.20	$68.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.21 / $55.63 / $61.20	Facility		$41.21	$55.63	$61.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $41.85 / $49.83	Professional		$41.85	$41.85	$49.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.26 / $62.80 / $81.79	Professional		$34.26	$62.80	$81.79
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $51.92 / $2,056.00 / $4,933.00	Facility		$51.92	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $11.88 / $11.88 / $11.88	Facility	53	$11.88	$11.88	$11.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $59.86 / $268.16	Professional		$43.80	$59.86	$268.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.09 / $35.19 / $50.08	Professional		$28.09	$35.19	$50.08
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $52.19 / $67.06 / $85.92	Professional		$52.19	$67.06	$85.92