Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,778.28 / $2,951.21	Facility		$125.89	$1,778.28	$2,951.21
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $2,290.87 / $3,630.78	Facility	50	$1,318.26	$2,290.87	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $177.83 / $501.19	Professional		$87.10	$177.83	$501.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $302.00 / $1,047.13	Professional	50	$138.04	$302.00	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $181.97	Professional		$77.62	$158.49	$181.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $162.18 / $263.03	Professional	50	$114.82	$162.18	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $281.84	Professional		$128.82	$144.54	$281.84
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $218.78 / $426.58	Professional	50	$218.78	$218.78	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $131.83 / $190.55	Facility		$102.33	$131.83	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $380.19	Professional		$162.18	$223.87	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $288.40	Professional		$87.10	$151.36	$288.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $1,412.54 / $2,951.21	Facility		$117.49	$1,412.54	$2,951.21
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $2,089.30 / $3,162.28	Facility	50	$794.33	$2,089.30	$3,162.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $190.55 / $380.19	Professional		$91.20	$190.55	$380.19
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $302.00 / $1,023.29	Professional	50	$134.90	$302.00	$1,023.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $144.54 / $269.15	Professional		$81.28	$144.54	$269.15
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 $91.20 / $154.88 / $269.15	Professional		$91.20	$154.88	$269.15