Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.10 / $598.30 / $1,677.54	Facility		$58.10	$598.30	$1,677.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $571.00 / $918.30 / $4,846.42	Facility	50	$571.00	$918.30	$4,846.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.10 / $90.80 / $171.27	Professional		$52.10	$90.80	$171.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.54 / $146.91 / $409.86	Professional	50	$48.54	$146.91	$409.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $62.43 / $72.87	Professional		$41.62	$62.43	$72.87
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $48.93 / $84.28 / $184.06	Professional	50	$48.93	$84.28	$184.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.11 / $1,265.40 / $2,971.63	Facility		$937.11	$1,265.40	$2,971.63
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $502.14 / $685.18 / $964.96	Facility	50	$502.14	$685.18	$964.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $51.12 / $81.23	Professional		$8.27	$51.12	$81.23
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $66.40 / $78.12 / $139.86	Professional	50	$66.40	$78.12	$139.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.97 / $48.74 / $58.49	Facility		$38.97	$48.74	$58.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.11 / $88.62 / $136.60	Professional		$67.11	$88.62	$136.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $74.40 / $131.10	Professional		$38.65	$74.40	$131.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.34 / $598.30 / $2,056.00	Facility		$70.34	$598.30	$2,056.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $571.00 / $918.30 / $3,703.86	Facility	50	$571.00	$918.30	$3,703.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.29 / $93.42 / $143.88	Professional		$53.29	$93.42	$143.88
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $48.54 / $204.93 / $409.86	Professional	50	$48.54	$204.93	$409.86
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 $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 $78.47 / $104.09 / $134.05	Professional		$78.47	$104.09	$134.05