Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,884.03 / $9,772.37	Facility		$794.33	$2,884.03	$9,772.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility	50	$3,090.30	$3,090.30	$3,090.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $776.25 / $2,630.27	Professional		$501.19	$776.25	$2,630.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,047.13	Professional		$489.78	$630.96	$1,047.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,380.38	Professional		$851.14	$1,000.00	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $891.25 / $1,258.93	Facility		$691.83	$891.25	$1,258.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $776.25 / $1,380.38	Professional		$575.44	$776.25	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $1,778.28	Professional		$457.09	$691.83	$1,778.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,884.03 / $8,511.38	Facility		$794.33	$2,884.03	$8,511.38
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility	50	$3,090.30	$3,090.30	$3,090.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $1,584.89	Professional		$562.34	$776.25	$1,584.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $1,096.48	Professional		$436.52	$616.60	$1,096.48
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 $562.34 / $676.08 / $891.25	Professional		$562.34	$676.08	$891.25