Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,938.19 / $8,866.62 / $16,420.09	Facility		$3,938.19	$8,866.62	$16,420.09
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,939.60 / $9,175.32 / $20,598.66	Facility	50	$4,939.60	$9,175.32	$20,598.66
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $88.38 / $88.38 / $88.38	Facility	AS	$88.38	$88.38	$88.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.88 / $517.45 / $1,059.01	Professional		$361.88	$517.45	$1,059.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.39 / $462.78 / $758.43	Professional		$231.39	$462.78	$758.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,594.09 / $8,270.87 / $11,418.75	Facility		$5,594.09	$8,270.87	$11,418.75
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,874.72 / $5,709.38 / $7,446.02	Facility	50	$3,874.72	$5,709.38	$7,446.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.40 / $658.33 / $1,098.40	Professional		$116.40	$658.33	$1,098.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $414.15 / $517.69 / $631.83	Facility		$414.15	$517.69	$631.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.23 / $547.76 / $754.55	Professional		$407.23	$547.76	$754.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.56 / $534.72 / $1,004.32	Professional		$382.56	$534.72	$1,004.32
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $736.56 / $8,766.82 / $18,293.06	Facility		$736.56	$8,766.82	$18,293.06
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $4,576.17 / $9,156.54 / $33,235.76	Facility	50	$4,576.17	$9,156.54	$33,235.76
Health Alliance Plan Facility/Professional Facility Modifier AS Low / Median / High Price $88.38 / $88.38 / $88.38	Facility	AS	$88.38	$88.38	$88.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $416.20 / $558.00 / $889.00	Professional		$416.20	$558.00	$889.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.80 / $352.45 / $549.47	Professional		$53.80	$352.45	$549.47
United Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $10,192.00 / $12,767.00	Facility		$4,500.00	$10,192.00	$12,767.00
United Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $563.60 / $729.34	Professional		$450.00	$563.60	$729.34