Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.66 / $1,211.75 / $4,162.28	Facility		$251.66	$1,211.75	$4,162.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $704.58 / $3,749.05 / $7,375.22	Facility	50	$704.58	$3,749.05	$7,375.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.90 / $407.68 / $721.54	Professional		$205.90	$407.68	$721.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $330.47 / $870.21 / $2,737.14	Professional	50	$330.47	$870.21	$2,737.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $378.19 / $378.19 / $423.31	Professional		$378.19	$378.19	$423.31
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $289.08 / $289.08 / $634.97	Professional	50	$289.08	$289.08	$634.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,987.66 / $2,332.92 / $3,160.75	Facility		$1,987.66	$2,332.92	$3,160.75
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,072.54 / $1,646.40 / $2,031.84	Facility	50	$1,072.54	$1,646.40	$2,031.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.28 / $355.58 / $495.66	Professional		$51.28	$355.58	$495.66
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $460.97 / $460.97 / $1,038.57	Professional	50	$460.97	$460.97	$1,038.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.12 / $225.91 / $270.18	Facility		$180.12	$225.91	$270.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $391.98 / $513.63 / $786.32	Professional		$391.98	$513.63	$786.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.99 / $359.31 / $719.88	Professional		$169.99	$359.31	$719.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $251.66 / $1,958.00 / $4,933.00	Facility		$251.66	$1,958.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,089.56 / $4,337.00 / $8,266.75	Facility	50	$1,089.56	$4,337.00	$8,266.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $232.29 / $435.45 / $721.54	Professional		$232.29	$435.45	$721.54
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $309.56 / $870.21 / $1,960.00	Professional	50	$309.56	$870.21	$1,960.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $344.54 / $515.48	Professional		$30.69	$344.54	$515.48
United Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $5,806.00 / $8,339.00	Facility		$1,450.00	$5,806.00	$8,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $415.16 / $532.78 / $688.13	Professional		$415.16	$532.78	$688.13