Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.96 / $879.80 / $3,208.84	Facility		$137.96	$879.80	$3,208.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,477.08 / $2,811.27 / $7,809.92	Facility	50	$1,477.08	$2,811.27	$7,809.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.67 / $177.69 / $316.11	Professional		$102.67	$177.69	$316.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.08 / $295.22 / $895.00	Professional	50	$154.08	$295.22	$895.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.86 / $168.86 / $168.86	Professional		$168.86	$168.86	$168.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.72 / $253.29 / $283.10	Professional	50	$158.72	$253.29	$283.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,829.97 / $2,147.84 / $2,909.98	Facility		$1,829.97	$2,147.84	$2,909.98
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,053.89 / $1,496.51 / $1,973.05	Facility	50	$1,053.89	$1,496.51	$1,973.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.90 / $165.23 / $271.45	Professional		$29.90	$165.23	$271.45
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $252.45 / $252.45 / $460.17	Professional	50	$252.45	$252.45	$460.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.82 / $123.79 / $148.22	Facility		$98.82	$123.79	$148.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.97 / $229.33 / $352.92	Professional		$173.97	$229.33	$352.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.17 / $171.34 / $325.87	Professional		$93.17	$171.34	$325.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $137.96 / $1,751.94 / $3,208.84	Facility		$137.96	$1,751.94	$3,208.84
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,396.92 / $2,811.27 / $4,764.20	Facility	50	$1,396.92	$2,811.27	$4,764.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $113.49 / $199.43 / $320.83	Professional		$113.49	$199.43	$320.83
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $174.00 / $476.31 / $895.00	Professional	50	$174.00	$476.31	$895.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $203.56 / $288.42	Professional		$163.59	$203.56	$288.42
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 $189.54 / $235.70 / $348.08	Professional		$189.54	$235.70	$348.08