Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $1,905.46 / $3,235.94	Facility		$144.54	$1,905.46	$3,235.94
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,412.54 / $2,754.23 / $4,073.80	Facility	50	$1,412.54	$2,754.23	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $630.96	Professional		$100.00	$190.55	$630.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $478.63 / $1,698.24	Professional	50	$181.97	$478.63	$1,698.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $173.78 / $199.53	Professional		$89.13	$173.78	$199.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $257.04 / $389.05	Professional	50	$151.36	$257.04	$389.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $234.42	Facility		$31.62	$31.62	$234.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $223.87 / $309.03	Professional		$97.72	$223.87	$309.03
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $251.19 / $457.09 / $457.09	Professional	50	$251.19	$457.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $154.88 / $218.78	Facility		$117.49	$154.88	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $407.38	Professional		$173.78	$239.88	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $331.13	Professional		$100.00	$169.82	$331.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,737.80 / $3,235.94	Facility		$141.25	$1,737.80	$3,235.94
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,412.54 / $2,630.27 / $4,073.80	Facility	50	$1,412.54	$2,630.27	$4,073.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $389.05	Professional		$109.65	$208.93	$389.05
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $338.84 / $1,148.15	Professional	50	$158.49	$338.84	$1,148.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $323.59	Professional		$93.33	$162.18	$323.59
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 $109.65 / $173.78 / $302.00	Professional		$109.65	$173.78	$302.00