Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,778.28 / $4,897.79	Facility		$169.82	$1,778.28	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $489.78 / $1,258.93 / $1,258.93	Facility	50	$489.78	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $251.19 / $851.14	Professional		$123.03	$251.19	$851.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $288.40 / $1,047.13 / $1,698.24	Professional	50	$288.40	$1,047.13	$1,698.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $263.03	Professional		$114.82	$177.83	$263.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $251.19 / $354.81 / $398.11	Professional	50	$251.19	$354.81	$398.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $295.12 / $295.12	Facility		$38.90	$295.12	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $309.03	Professional		$194.98	$295.12	$309.03
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $316.23 / $630.96 / $630.96	Professional	50	$316.23	$630.96	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $218.78 / $416.87	Professional		$123.03	$218.78	$416.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,778.28 / $4,897.79	Facility		$169.82	$1,778.28	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $489.78 / $489.78 / $1,258.93	Facility	50	$489.78	$489.78	$1,258.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $269.15 / $524.81	Professional		$128.82	$269.15	$524.81
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $251.19 / $562.34 / $1,318.26	Professional	50	$251.19	$562.34	$1,318.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $213.80 / $398.11	Professional		$107.15	$213.80	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,778.28 / $4,073.80	Facility		$691.83	$1,778.28	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $223.87 / $363.08	Professional		$134.90	$223.87	$363.08