Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $799.00 / $2,869.92 / $7,456.17	Facility		$799.00	$2,869.92	$7,456.17
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,090.34 / $3,090.34 / $3,090.34	Facility	50	$3,090.34	$3,090.34	$3,090.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $499.31 / $730.01 / $1,733.85	Professional		$499.31	$730.01	$1,733.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $562.21 / $852.90 / $1,162.74	Professional		$562.21	$852.90	$1,162.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,085.51 / $4,795.18 / $6,496.72	Facility		$4,085.51	$4,795.18	$6,496.72
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,352.86 / $3,008.09 / $4,236.43	Facility	50	$2,352.86	$3,008.09	$4,236.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.76 / $643.91 / $1,597.78	Professional		$163.76	$643.91	$1,597.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $573.27 / $718.45 / $859.91	Facility		$573.27	$718.45	$859.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $558.23 / $755.78 / $946.58	Professional		$558.23	$755.78	$946.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $445.50 / $687.40 / $1,372.98	Professional		$445.50	$687.40	$1,372.98
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $769.41 / $2,869.92 / $8,559.25	Facility		$769.41	$2,869.92	$8,559.25
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,090.34 / $3,090.34 / $3,090.34	Facility	50	$3,090.34	$3,090.34	$3,090.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $759.66 / $1,248.00	Professional		$575.50	$759.66	$1,248.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $514.53 / $758.12	Professional		$65.66	$514.53	$758.12
United Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $5,806.00 / $8,339.00	Facility		$1,450.00	$5,806.00	$8,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $571.95 / $686.14 / $965.12	Professional		$571.95	$686.14	$965.12