Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.21 / $1,325.27 / $2,959.63	Facility		$223.21	$1,325.27	$2,959.63
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $96.97 / $458.27 / $662.64	Facility	52	$96.97	$458.27	$662.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.79 / $38.79 / $265.06	Facility	53	$38.79	$38.79	$265.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $203.63 / $1,325.28	Professional		$147.13	$203.63	$1,325.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.11 / $171.73 / $272.60	Professional		$137.11	$171.73	$272.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,108.63 / $1,639.11 / $2,197.19	Facility		$1,108.63	$1,639.11	$2,197.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $162.86 / $260.57	Professional		$41.60	$162.86	$260.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.11 / $178.92 / $215.94	Facility		$143.11	$178.92	$215.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $961.51 / $1,190.44 / $1,728.42	Professional		$961.51	$1,190.44	$1,728.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.24 / $340.84 / $1,947.34	Professional		$158.24	$340.84	$1,947.34
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $203.63 / $1,446.30 / $2,959.63	Facility		$203.63	$1,446.30	$2,959.63
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $96.97 / $458.27 / $662.64	Facility	52	$96.97	$458.27	$662.64
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $38.79 / $38.79 / $265.06	Facility	53	$38.79	$38.79	$265.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $150.87 / $256.00 / $1,467.02	Professional		$150.87	$256.00	$1,467.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $833.40 / $1,043.23 / $1,506.82	Professional		$833.40	$1,043.23	$1,506.82
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 $215.93 / $1,176.60 / $1,680.87	Professional		$215.93	$1,176.60	$1,680.87