Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $2,041.74 / $4,897.79	Facility		$67.61	$2,041.74	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	50	$588.84	$588.84	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $173.78	Professional		$47.86	$83.18	$173.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $141.25 / $436.52	Professional	50	$74.13	$141.25	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.12 / $66.07	Professional		$43.65	$50.12	$66.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $70.79 / $134.90	Professional	50	$70.79	$70.79	$134.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $75.86 / $75.86	Facility		$15.14	$75.86	$75.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $144.54 / $151.36	Professional		$75.86	$144.54	$151.36
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $162.18 / $288.40	Professional	50	$162.18	$162.18	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $91.20	Facility		$57.54	$57.54	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $114.82	Professional		$81.28	$112.20	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $151.36	Professional		$47.86	$83.18	$151.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $616.60 / $4,897.79	Facility		$69.18	$616.60	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	50	$588.84	$588.84	$588.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $177.83	Professional		$50.12	$97.72	$177.83
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $134.90 / $489.78	Professional	50	$74.13	$134.90	$489.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $79.43 / $138.04	Professional		$44.67	$79.43	$138.04
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 $54.95 / $81.28 / $125.89	Professional		$54.95	$81.28	$125.89