Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $568.12 / $1,543.18 / $2,974.84	Facility		$568.12	$1,543.18	$2,974.84
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $160.44 / $160.44 / $284.06	Facility	52	$160.44	$160.44	$284.06
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $64.18 / $64.18 / $113.62	Facility	53	$64.18	$64.18	$113.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.06 / $430.62 / $766.29	Professional		$262.06	$430.62	$766.29
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $50.17 / $84.60 / $113.62	Professional	53	$50.17	$84.60	$113.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $210.75 / $255.29 / $478.40	Professional		$210.75	$255.29	$478.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.10 / $1,277.57 / $1,763.81	Facility		$864.10	$1,277.57	$1,763.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.58 / $315.55 / $422.60	Professional		$63.58	$315.55	$422.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $236.67 / $295.87 / $357.50	Facility		$236.67	$295.87	$357.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $425.29 / $540.90 / $752.40	Professional		$425.29	$540.90	$752.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.04 / $489.24 / $952.54	Professional		$271.04	$489.24	$952.54
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $432.42 / $1,438.50 / $3,542.87	Facility		$432.42	$1,438.50	$3,542.87
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $160.44 / $160.44 / $284.06	Facility	52	$160.44	$160.44	$284.06
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $64.18 / $64.18 / $113.62	Facility	53	$64.18	$64.18	$113.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $265.88 / $540.17 / $780.59	Professional		$265.88	$540.17	$780.59
Health Alliance Plan Facility/Professional Professional Modifier 53 Low / Median / High Price $51.62 / $89.42 / $163.60	Professional	53	$51.62	$89.42	$163.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $374.94 / $477.36 / $685.14	Professional		$374.94	$477.36	$685.14
United Facility/Professional Facility Modifier Low / Median / High Price $558.00 / $3,523.00 / $6,029.00	Facility		$558.00	$3,523.00	$6,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $467.67 / $634.49 / $891.53	Professional		$467.67	$634.49	$891.53