Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.44 / $2,914.05 / $6,906.00	Facility		$546.44	$2,914.05	$6,906.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $105.24 / $109.29 / $582.80	Facility	53	$105.24	$109.29	$582.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.81 / $633.94 / $3,367.36	Professional		$365.81	$633.94	$3,367.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,885.42 / $1,885.42 / $1,885.42	Professional		$1,885.42	$1,885.42	$1,885.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,806.46 / $10,336.20 / $14,003.92	Facility		$8,806.46	$10,336.20	$14,003.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.11 / $407.85 / $691.27	Professional		$114.11	$407.85	$691.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.58 / $490.49 / $588.59	Facility		$391.58	$490.49	$588.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,961.61 / $2,554.92 / $3,868.62	Professional		$1,961.61	$2,554.92	$3,868.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.96 / $965.29 / $3,336.86	Professional		$368.96	$965.29	$3,336.86
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $426.74 / $2,877.00 / $7,187.14	Facility		$426.74	$2,877.00	$7,187.14
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $105.24 / $105.24 / $561.23	Facility	53	$105.24	$105.24	$561.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $426.74 / $725.92 / $3,125.33	Professional		$426.74	$725.92	$3,125.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $226.86 / $1,839.68 / $2,762.88	Professional		$226.86	$1,839.68	$2,762.88
United Facility/Professional Facility Modifier Low / Median / High Price $4,635.00 / $10,192.00 / $12,767.00	Facility		$4,635.00	$10,192.00	$12,767.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,498.32 / $1,713.23 / $2,566.35	Professional		$1,498.32	$1,713.23	$2,566.35