Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.65 / $2,376.10 / $4,933.00	Facility		$178.65	$2,376.10	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,442.38 / $4,501.84 / $4,501.84	Facility	50	$2,442.38	$4,501.84	$4,501.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.99 / $170.15 / $326.33	Professional		$121.99	$170.15	$326.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.25 / $146.43 / $239.96	Professional		$133.25	$146.43	$239.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $656.98 / $765.74 / $1,037.45	Facility		$656.98	$765.74	$1,037.45
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $353.96 / $541.21 / $666.91	Facility	50	$353.96	$541.21	$666.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $218.90 / $470.74	Professional		$36.18	$218.90	$470.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.63 / $176.36 / $194.04	Facility		$130.63	$176.36	$194.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.57 / $150.68 / $173.30	Professional		$126.57	$150.68	$173.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.96 / $187.16 / $275.25	Professional		$108.96	$187.16	$275.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $170.15 / $2,056.00 / $4,933.00	Facility		$170.15	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,442.38 / $2,442.38 / $4,501.84	Facility	50	$2,442.38	$2,442.38	$4,501.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $170.15 / $332.35	Professional		$131.29	$170.15	$332.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.98 / $174.12 / $251.60	Professional		$135.98	$174.12	$251.60
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $155.87 / $184.50 / $255.85	Professional		$155.87	$184.50	$255.85