Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.79 / $826.10 / $4,933.00	Facility		$83.79	$826.10	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $834.43 / $6,334.48 / $6,334.48	Facility	50	$834.43	$6,334.48	$6,334.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.34 / $105.81 / $188.55	Professional		$57.34	$105.81	$188.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $86.95 / $86.95	Professional		$86.95	$86.95	$86.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.35 / $146.31 / $343.59	Facility		$108.35	$146.31	$343.59
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $68.01 / $89.26 / $116.01	Facility	50	$68.01	$89.26	$116.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $94.61 / $153.27	Professional		$17.69	$94.61	$153.27
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.79 / $151.79 / $278.01	Professional	50	$151.79	$151.79	$278.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.36 / $76.18 / $91.41	Facility		$60.36	$76.18	$91.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $139.76 / $216.28	Professional		$105.33	$139.76	$216.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $95.69 / $190.10	Professional		$55.80	$95.69	$190.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $83.79 / $826.10 / $5,704.35	Facility		$83.79	$826.10	$5,704.35
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $834.43 / $6,334.48 / $6,334.48	Facility	50	$834.43	$6,334.48	$6,334.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $122.21 / $192.33	Professional		$76.23	$122.21	$192.33
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 $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.04 / $109.57 / $157.94	Professional		$79.04	$109.57	$157.94