Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $954.99 / $4,168.69	Facility		$75.86	$954.99	$4,168.69
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $1,698.24 / $3,467.37	Facility	50	$851.14	$1,698.24	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $204.17 / $724.44	Professional		$57.54	$204.17	$724.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.10 / $218.78 / $1,148.15	Professional	50	$87.10	$218.78	$1,148.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $251.19	Professional		$51.29	$81.28	$251.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $91.20 / $323.59	Professional	50	$72.44	$91.20	$323.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $173.78	Facility		$87.10	$87.10	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $371.54	Professional		$93.33	$173.78	$371.54
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $186.21 / $251.19 / $741.31	Professional	50	$186.21	$251.19	$741.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $85.11 / $123.03	Facility		$66.07	$85.11	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $478.63	Professional		$208.93	$288.40	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $165.96 / $346.74	Professional		$54.95	$165.96	$346.74
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $954.99 / $4,168.69	Facility		$75.86	$954.99	$4,168.69
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $758.58 / $1,318.26 / $3,467.37	Facility	50	$758.58	$1,318.26	$3,467.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $213.80 / $467.74	Professional		$60.26	$213.80	$467.74
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $257.04 / $831.76	Professional	50	$85.11	$257.04	$831.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $346.74	Professional		$48.98	$102.33	$346.74
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 $61.66 / $147.91 / $257.04	Professional		$61.66	$147.91	$257.04