Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $3,467.37 / $6,918.31	Facility		$588.84	$3,467.37	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,623.41 / $6,165.95 / $10,000.00	Facility	50	$5,623.41	$6,165.95	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $2,137.96	Professional		$371.54	$575.44	$2,137.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $724.44 / $1,288.25 / $1,949.84	Professional	50	$724.44	$1,288.25	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $436.52 / $602.56	Professional		$204.17	$436.52	$602.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $616.60 / $660.69 / $870.96	Professional	50	$616.60	$660.69	$870.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $1,000.00	Professional		$616.60	$724.44	$1,000.00
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,071.52 / $1,071.52 / $1,096.48	Professional	50	$1,071.52	$1,071.52	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $645.65 / $912.01	Facility		$501.19	$645.65	$912.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $575.44 / $1,000.00	Professional		$426.58	$575.44	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $1,000.00	Professional		$354.81	$501.19	$1,000.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,951.21 / $6,918.31	Facility		$588.84	$2,951.21	$6,918.31
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $5,623.41 / $6,165.95 / $10,000.00	Facility	50	$5,623.41	$6,165.95	$10,000.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,202.26	Professional		$398.11	$575.44	$1,202.26
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $870.96 / $1,174.90 / $1,905.46	Professional	50	$870.96	$1,174.90	$1,905.46
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $758.58	Professional		$331.13	$467.74	$758.58
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 $407.38 / $489.78 / $645.65	Professional		$407.38	$489.78	$645.65