Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $364.39 / $1,210.40 / $2,740.00	Facility		$364.39	$1,210.40	$2,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $67.22 / $182.20 / $889.09	Facility	52	$67.22	$182.20	$889.09
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $26.89 / $72.88 / $1,675.00	Facility	53	$26.89	$72.88	$1,675.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $212.06 / $364.40	Professional		$97.14	$212.06	$364.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.98 / $106.30 / $183.99	Professional		$92.98	$106.30	$183.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $666.90 / $996.33 / $2,281.25	Facility		$666.90	$996.33	$2,281.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $149.02 / $188.23	Professional		$25.34	$149.02	$188.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.37 / $125.01 / $149.72	Facility		$99.37	$125.01	$149.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.70 / $339.26 / $479.79	Professional		$270.70	$339.26	$479.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.83 / $248.40 / $543.88	Professional		$112.83	$248.40	$543.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $302.02 / $1,191.35 / $3,412.00	Facility		$302.02	$1,191.35	$3,412.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $67.22 / $889.09 / $889.09	Facility	52	$67.22	$889.09	$889.09
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $26.89 / $1,675.00 / $1,675.00	Facility	53	$26.89	$1,675.00	$1,675.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $297.45 / $437.27	Professional		$107.04	$297.45	$437.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.54 / $269.57 / $388.49	Professional		$216.54	$269.57	$388.49
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 $308.44 / $407.55 / $592.79	Professional		$308.44	$407.55	$592.79