Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,862.09 / $4,897.79	Facility		$158.49	$1,862.09	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,584.89 / $4,265.80 / $10,000.00	Facility	50	$1,584.89	$4,265.80	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $501.19 / $1,380.38	Professional		$97.72	$501.19	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $323.59 / $3,467.37 / $4,677.35	Professional	50	$323.59	$3,467.37	$4,677.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $100.00 / $186.21	Professional		$43.65	$100.00	$186.21
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $128.82 / $194.98	Professional	50	$117.49	$128.82	$194.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $147.91 / $147.91	Facility		$29.51	$147.91	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $229.09	Professional		$147.91	$218.78	$229.09
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $234.42 / $1,148.15	Professional	50	$199.53	$234.42	$1,148.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $316.23 / $870.96	Professional		$102.33	$316.23	$870.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,479.11 / $4,897.79	Facility		$158.49	$1,479.11	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $4,265.80 / $10,000.00	Facility	50	$1,380.38	$4,265.80	$10,000.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $524.81 / $933.25	Professional		$104.71	$524.81	$933.25
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $1,584.89 / $3,467.37	Professional	50	$446.68	$1,584.89	$3,467.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $316.23 / $758.58	Professional		$109.65	$316.23	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $2,511.89 / $5,495.41	Facility		$954.99	$2,511.89	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $416.87 / $758.58	Professional		$114.82	$416.87	$758.58