Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $4,897.79 / $9,120.11	Facility		$676.08	$4,897.79	$9,120.11
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $7,585.78 / $8,128.31	Facility	50	$3,890.45	$7,585.78	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $724.44 / $1,949.84	Professional		$478.63	$724.44	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $954.99	Professional		$426.58	$549.54	$954.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $501.19 / $501.19	Facility		$158.49	$501.19	$501.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $851.14 / $1,202.26	Professional		$165.96	$851.14	$1,202.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $630.96 / $724.44	Facility		$398.11	$630.96	$724.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $676.08 / $776.25	Professional		$588.84	$676.08	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $1,548.82	Professional		$478.63	$676.08	$1,548.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $4,677.35 / $8,912.51	Facility		$676.08	$4,677.35	$8,912.51
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $7,585.78 / $8,128.31	Facility	50	$3,890.45	$7,585.78	$8,128.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $1,288.25	Professional		$501.19	$676.08	$1,288.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $1,174.90	Professional		$436.52	$616.60	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $5,754.40 / $9,549.93	Facility		$794.33	$5,754.40	$9,549.93
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $645.65 / $891.25	Professional		$489.78	$645.65	$891.25