Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $2,041.74 / $4,897.79	Facility		$158.49	$2,041.74	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	50	$489.78	$489.78	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $229.09 / $758.58	Professional		$112.20	$229.09	$758.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $794.33 / $1,659.59	Professional	50	$36.31	$794.33	$1,659.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $181.97 / $181.97	Facility		$112.20	$181.97	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $398.11	Professional		$181.97	$269.15	$398.11
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $288.40 / $501.19 / $588.84	Professional	50	$288.40	$501.19	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $416.87	Professional		$112.20	$181.97	$416.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $645.65 / $4,897.79	Facility		$158.49	$645.65	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	50	$489.78	$489.78	$489.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $446.68	Professional		$131.83	$239.88	$446.68
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $489.78 / $1,258.93	Professional	50	$158.49	$489.78	$1,258.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $407.38	Professional		$100.00	$181.97	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,778.28 / $4,073.80	Facility		$691.83	$1,778.28	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $309.03	Professional		$112.20	$204.17	$309.03