Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $794.33 / $4,897.79	Facility		$100.00	$794.33	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $218.78	Professional		$56.23	$93.33	$218.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $269.15 / $549.54	Professional	50	$158.49	$269.15	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $97.72	Professional		$56.23	$56.23	$97.72
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $158.49 / $218.78	Professional	50	$147.91	$158.49	$218.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $56.23	Facility		$17.78	$17.78	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $154.88 / $177.83	Professional		$64.57	$154.88	$177.83
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $190.55 / $309.03 / $309.03	Professional	50	$190.55	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $165.96	Professional		$56.23	$93.33	$165.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $288.40 / $4,897.79	Facility		$100.00	$288.40	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $107.15 / $181.97	Professional		$58.88	$107.15	$181.97
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $131.83 / $223.87 / $524.81	Professional	50	$131.83	$223.87	$524.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $89.13 / $151.36	Professional		$51.29	$89.13	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,258.93 / $2,041.74	Facility		$467.74	$1,258.93	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $141.25	Professional		$63.10	$93.33	$141.25