Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $2,041.74 / $4,897.79	Facility		$263.03	$2,041.74	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $2,630.27 / $6,760.83	Facility	50	$1,096.48	$2,630.27	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $416.87 / $1,288.25	Professional		$190.55	$416.87	$1,288.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $302.00 / $645.65 / $2,754.23	Professional	50	$302.00	$645.65	$2,754.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $426.58	Professional		$162.18	$245.47	$426.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $371.54 / $630.96	Professional	50	$245.47	$371.54	$630.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $691.83	Professional		$309.03	$426.58	$691.83
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $457.09 / $457.09 / $1,047.13	Professional	50	$457.09	$457.09	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $281.84 / $398.11	Facility		$218.78	$281.84	$398.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $537.03 / $912.01	Professional		$398.11	$537.03	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $363.08 / $724.44	Professional		$186.21	$363.08	$724.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $1,479.11 / $4,265.80	Facility		$263.03	$1,479.11	$4,265.80
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $2,630.27 / $5,370.32	Facility	50	$1,096.48	$2,630.27	$5,370.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $457.09 / $870.96	Professional		$208.93	$457.09	$870.96
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $281.84 / $707.95 / $2,691.53	Professional	50	$281.84	$707.95	$2,691.53
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $323.59 / $660.69	Professional		$158.49	$323.59	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,981.07 / $7,244.36	Facility		$1,513.56	$3,981.07	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $380.19 / $588.84	Professional		$229.09	$380.19	$588.84