Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,174.90 / $4,897.79	Facility		$346.74	$1,174.90	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility	50	$2,398.83	$2,398.83	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $851.14	Professional		$218.78	$316.23	$851.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.87 / $630.96 / $1,862.09	Professional	50	$416.87	$630.96	$1,862.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $245.47	Professional		$162.18	$218.78	$245.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	50	$354.81	$354.81	$354.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $147.91 / $147.91	Facility		$134.90	$147.91	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $354.81	Professional		$204.17	$323.59	$354.81
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $457.09 / $457.09	Professional	50	$380.19	$457.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $229.09 / $257.04	Facility		$190.55	$229.09	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $239.88	Professional		$223.87	$223.87	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $288.40 / $524.81	Professional		$177.83	$288.40	$524.81
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,148.15 / $4,897.79	Facility		$346.74	$1,148.15	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility	50	$2,398.83	$2,398.83	$2,398.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $316.23 / $562.34	Professional		$234.42	$316.23	$562.34
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $630.96 / $1,023.29	Professional	50	$83.18	$630.96	$1,023.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $245.47 / $371.54	Professional		$181.97	$245.47	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,584.89 / $4,073.80	Facility		$426.58	$1,584.89	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $426.58	Professional		$234.42	$323.59	$426.58