Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $289.22 / $686.45	Facility		$67.00	$289.22	$686.45
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $32,021.65 / $32,021.65 / $32,021.65	Facility	50	$32,021.65	$32,021.65	$32,021.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $99.76 / $162.66	Professional		$56.92	$99.76	$162.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.53 / $163.58 / $471.24	Professional	50	$54.53	$163.58	$471.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $55.46 / $83.19	Professional		$50.20	$55.46	$83.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.68 / $460.89 / $624.42	Facility		$392.68	$460.89	$624.42
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $226.14 / $312.20 / $406.58	Facility	50	$226.14	$312.20	$406.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.30 / $74.27 / $134.87	Professional		$13.30	$74.27	$134.87
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $106.62 / $125.43 / $269.24	Professional	50	$106.62	$125.43	$269.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.25 / $62.90 / $75.48	Facility		$49.25	$62.90	$75.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $134.21 / $207.05	Professional		$99.43	$134.21	$207.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $97.40 / $184.78	Professional		$49.64	$97.40	$184.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $289.22 / $1,842.63	Facility		$67.00	$289.22	$1,842.63
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $32,021.65 / $32,021.65 / $32,021.65	Facility	50	$32,021.65	$32,021.65	$32,021.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $64.52 / $118.10 / $183.68	Professional		$64.52	$118.10	$183.68
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $54.53 / $471.24 / $471.24	Professional	50	$54.53	$471.24	$471.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $101.78 / $144.21	Professional		$81.79	$101.78	$144.21
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,209.00 / $1,844.00	Facility		$300.00	$1,209.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.91 / $133.47 / $180.65	Professional		$113.91	$133.47	$180.65