Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $263.03 / $4,897.79	Facility		$151.36	$263.03	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $467.74 / $645.65 / $1,737.80	Facility	50	$467.74	$645.65	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $380.19	Professional		$97.72	$141.25	$380.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $346.74 / $933.25	Professional	50	$169.82	$346.74	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $131.83 / $151.36	Professional		$66.07	$131.83	$151.36
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $177.83 / $194.98 / $281.84	Professional	50	$177.83	$194.98	$281.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $251.19	Facility		$33.11	$33.11	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $251.19	Professional		$138.04	$234.42	$251.19
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $223.87 / $331.13 / $331.13	Professional	50	$223.87	$331.13	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $154.88 / $234.42	Facility		$125.89	$154.88	$234.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $316.23	Professional		$128.82	$177.83	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $257.04	Professional		$100.00	$144.54	$257.04
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $338.84 / $4,897.79	Facility		$141.25	$338.84	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $331.13 / $575.44 / $1,737.80	Facility	50	$331.13	$575.44	$1,737.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $288.40	Professional		$107.15	$158.49	$288.40
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $363.08 / $977.24	Professional	50	$169.82	$363.08	$977.24
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $234.42	Professional		$91.20	$138.04	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $870.96 / $1,737.80	Facility		$229.09	$870.96	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $186.21	Professional		$112.20	$144.54	$186.21