Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,648.56 / $7,635.88 / $13,940.98	Facility		$3,648.56	$7,635.88	$13,940.98
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $426.34 / $426.34 / $426.34	Facility	52	$426.34	$426.34	$426.34
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $170.54 / $170.54 / $170.54	Facility	53	$170.54	$170.54	$170.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $620.03 / $783.77 / $1,491.37	Professional		$620.03	$783.77	$1,491.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $643.47 / $707.58 / $859.28	Professional		$643.47	$707.58	$859.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,336.18 / $8,638.70 / $20,714.02	Facility		$6,336.18	$8,638.70	$20,714.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.61 / $694.46 / $1,148.79	Professional		$176.61	$694.46	$1,148.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $631.60 / $789.50 / $968.97	Facility		$631.60	$789.50	$968.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $617.02 / $836.51 / $1,145.84	Professional		$617.02	$836.51	$1,145.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.13 / $834.06 / $1,743.83	Professional		$650.13	$834.06	$1,743.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,409.92 / $7,477.72 / $13,940.98	Facility		$2,409.92	$7,477.72	$13,940.98
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $426.34 / $426.34 / $426.34	Facility	52	$426.34	$426.34	$426.34
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $170.54 / $170.54 / $170.54	Facility	53	$170.54	$170.54	$170.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $659.42 / $852.67 / $1,441.44	Professional		$659.42	$852.67	$1,441.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $552.34 / $844.36	Professional		$65.50	$552.34	$844.36
United Facility/Professional Facility Modifier Low / Median / High Price $4,200.00 / $10,192.00 / $12,767.00	Facility		$4,200.00	$10,192.00	$12,767.00
United Facility/Professional Professional Modifier Low / Median / High Price $700.49 / $929.89 / $1,174.86	Professional		$700.49	$929.89	$1,174.86