Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.11 / $92.56 / $4,933.00	Facility		$43.11	$92.56	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $0.62 / $0.62 / $0.62	Facility	50	$0.62	$0.62	$0.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $48.29 / $86.81	Professional		$32.96	$48.29	$86.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.44 / $64.14 / $171.00	Professional	50	$40.44	$64.14	$171.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $44.78 / $71.75	Professional		$22.39	$44.78	$71.75
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $48.40 / $48.40 / $73.68	Professional	50	$48.40	$48.40	$73.68
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 / $407.18	Facility	50	$226.14	$312.20	$407.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.38 / $49.30 / $85.05	Professional		$8.38	$49.30	$85.05
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.09 / $101.18 / $119.04	Professional	50	$79.09	$101.18	$119.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.53 / $39.64 / $47.57	Facility		$31.53	$39.64	$47.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $60.44 / $94.04	Professional		$45.62	$60.44	$94.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $48.26 / $85.18	Professional		$28.88	$48.26	$85.18
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $48.48 / $92.56 / $4,933.00	Facility		$48.48	$92.56	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $0.62 / $0.62 / $0.62	Facility	50	$0.62	$0.62	$0.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $41.91 / $52.76 / $82.85	Professional		$41.91	$52.76	$82.85
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $40.44 / $64.14 / $171.00	Professional	50	$40.44	$64.14	$171.00
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 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.31 / $59.70 / $77.94	Professional		$47.31	$59.70	$77.94