Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.92 / $402.08 / $2,056.00	Facility		$70.92	$402.08	$2,056.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $322.32 / $1,597.76 / $4,991.22	Facility	50	$322.32	$1,597.76	$4,991.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $94.61 / $141.79	Professional		$65.33	$94.61	$141.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.06 / $159.18 / $840.00	Professional	50	$53.06	$159.18	$840.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $104.06 / $104.06 / $152.33	Professional	50	$104.06	$104.06	$152.33
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 / $321.13 / $390.27	Facility	50	$226.14	$321.13	$390.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.48 / $84.68 / $124.70	Professional		$15.48	$84.68	$124.70
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.97 / $127.02 / $181.35	Professional	50	$107.97	$127.02	$181.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.43 / $64.84 / $77.81	Facility		$50.43	$64.84	$77.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.39 / $92.90 / $145.93	Professional		$68.39	$92.90	$145.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $84.92 / $144.25	Professional		$50.49	$84.92	$144.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.92 / $402.08 / $2,056.00	Facility		$70.92	$402.08	$2,056.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $501.70 / $1,597.75 / $4,991.22	Facility	50	$501.70	$1,597.75	$4,991.22
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $68.29 / $98.06 / $153.88	Professional		$68.29	$98.06	$153.88
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $66.61 / $146.75 / $528.00	Professional	50	$66.61	$146.75	$528.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $68.01 / $96.85	Professional		$54.68	$68.01	$96.85
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 $79.43 / $114.39 / $152.74	Professional		$79.43	$114.39	$152.74