Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.06 / $979.00 / $2,631.42	Facility		$78.06	$979.00	$2,631.42
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $853.58 / $2,179.10 / $4,221.83	Facility	50	$853.58	$2,179.10	$4,221.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $177.66 / $421.26	Professional		$54.79	$177.66	$421.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.75 / $334.11 / $835.00	Professional	50	$91.75	$334.11	$835.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.94 / $226.73 / $379.13	Professional		$201.94	$226.73	$379.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $89.42 / $89.42 / $340.10	Professional	50	$89.42	$89.42	$340.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $787.43 / $924.22 / $1,252.17	Facility		$787.43	$924.22	$1,252.17
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $424.89 / $626.08 / $804.94	Facility	50	$424.89	$626.08	$804.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.16 / $97.49 / $201.58	Professional		$14.16	$97.49	$201.58
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $187.48 / $187.48 / $745.64	Professional	50	$187.48	$187.48	$745.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.68 / $70.09 / $84.12	Facility		$55.68	$70.09	$84.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $209.99 / $273.82 / $416.51	Professional		$209.99	$273.82	$416.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.82 / $164.64 / $319.36	Professional		$51.82	$164.64	$319.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.06 / $979.00 / $2,878.00	Facility		$78.06	$979.00	$2,878.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $853.58 / $2,472.23 / $4,221.83	Facility	50	$853.58	$2,472.23	$4,221.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.18 / $208.85 / $416.00	Professional		$75.18	$208.85	$416.00
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $92.00 / $325.61 / $624.00	Professional	50	$92.00	$325.61	$624.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $189.87 / $237.32 / $339.00	Professional		$189.87	$237.32	$339.00
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $171.95 / $226.70 / $284.33	Professional		$171.95	$226.70	$284.33