Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $553.14 / $1,472.31 / $3,587.17	Facility		$553.14	$1,472.31	$3,587.17
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $87.21 / $87.21 / $233.29	Facility	52	$87.21	$87.21	$233.29
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.88 / $34.88 / $93.32	Facility	53	$34.88	$34.88	$93.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $212.80 / $577.16	Professional		$71.73	$212.80	$577.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $180.62 / $346.27	Professional		$79.29	$180.62	$346.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $843.84 / $1,247.63 / $1,722.47	Facility		$843.84	$1,247.63	$1,722.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $172.27 / $275.64	Professional		$34.71	$172.27	$275.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.84 / $161.47 / $194.12	Facility		$128.84	$161.47	$194.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $347.74 / $436.09 / $619.76	Professional		$347.74	$436.09	$619.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.21 / $356.11 / $698.76	Professional		$148.21	$356.11	$698.76
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $466.57 / $1,775.00 / $5,098.35	Facility		$466.57	$1,775.00	$5,098.35
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $87.21 / $87.21 / $233.29	Facility	52	$87.21	$87.21	$233.29
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $34.88 / $34.88 / $93.32	Facility	53	$34.88	$34.88	$93.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $71.56 / $304.72 / $582.33	Professional		$71.56	$304.72	$582.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $271.53 / $336.80 / $485.00	Professional		$271.53	$336.80	$485.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $4,857.00 / $6,036.00	Facility		$1,050.00	$4,857.00	$6,036.00
United Facility/Professional Professional Modifier Low / Median / High Price $293.76 / $460.36 / $581.99	Professional		$293.76	$460.36	$581.99