Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $2,290.87 / $5,248.07	Facility		$83.18	$2,290.87	$5,248.07
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $831.76 / $6,309.57 / $6,309.57	Facility	50	$831.76	$6,309.57	$6,309.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $112.20 / $645.65	Professional		$57.54	$112.20	$645.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $363.08 / $1,071.52	Professional	50	$199.53	$363.08	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $93.33	Professional		$45.71	$60.26	$93.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $16.22 / $58.88	Facility		$16.22	$16.22	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $141.25 / $186.21	Professional		$58.88	$141.25	$186.21
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $151.36 / $275.42	Professional	50	$151.36	$151.36	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $93.33 / $134.90	Facility		$72.44	$93.33	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $251.19	Professional		$107.15	$147.91	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $95.50 / $199.53	Professional		$56.23	$95.50	$199.53
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $1,288.25 / $5,754.40	Facility		$83.18	$1,288.25	$5,754.40
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $831.76 / $831.76 / $6,309.57	Facility	50	$831.76	$831.76	$6,309.57
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $125.89 / $239.88	Professional		$61.66	$125.89	$239.88
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $380.19	Professional	50	$199.53	$199.53	$380.19
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $169.82	Professional		$52.48	$93.33	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,778.28 / $4,073.80	Facility		$537.03	$1,778.28	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $147.91	Professional		$57.54	$85.11	$147.91