Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $577.66 / $3,439.50 / $5,740.55	Facility		$577.66	$3,439.50	$5,740.55
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,594.24 / $6,125.57 / $10,050.44	Facility	50	$5,594.24	$6,125.57	$10,050.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.14 / $556.29 / $1,325.25	Professional		$366.14	$556.29	$1,325.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $880.76 / $880.76 / $1,175.35	Professional	50	$880.76	$880.76	$1,175.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.22 / $456.42 / $841.08	Professional		$420.22	$456.42	$841.08
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $924.25 / $924.25 / $939.97	Professional	50	$924.25	$924.25	$939.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,574.78 / $3,022.03 / $4,094.38	Facility		$2,574.78	$3,022.03	$4,094.38
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,389.34 / $2,132.71 / $2,776.10	Facility	50	$1,389.34	$2,132.71	$2,776.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $610.71 / $1,058.05	Professional		$119.91	$610.71	$1,058.05
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $916.06 / $1,077.72 / $1,096.09	Professional	50	$916.06	$1,077.72	$1,096.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $413.41 / $519.66 / $620.12	Facility		$413.41	$519.66	$620.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $410.13 / $555.09 / $695.84	Professional		$410.13	$555.09	$695.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.70 / $493.17 / $997.97	Professional		$331.70	$493.17	$997.97
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $575.38 / $3,121.50 / $6,445.00	Facility		$575.38	$3,121.50	$6,445.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $5,594.24 / $6,125.57 / $10,050.44	Facility	50	$5,594.24	$6,125.57	$10,050.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $394.00 / $565.91 / $916.77	Professional		$394.00	$565.91	$916.77
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $880.76 / $1,175.35 / $1,175.35	Professional	50	$880.76	$1,175.35	$1,175.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $383.10 / $576.72	Professional		$65.66	$383.10	$576.72
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 $430.44 / $497.82 / $711.55	Professional		$430.44	$497.82	$711.55