Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,174.90 / $4,897.79	Facility		$338.84	$1,174.90	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,467.37 / $5,128.61 / $5,128.61	Facility	50	$3,467.37	$5,128.61	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $1,230.27	Professional		$234.42	$426.58	$1,230.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $645.65 / $676.08 / $2,691.53	Professional	50	$645.65	$676.08	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $302.00	Professional		$194.98	$229.09	$302.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $316.23 / $316.23 / $316.23	Professional	50	$316.23	$316.23	$316.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $380.19 / $380.19	Facility		$229.09	$380.19	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $302.00 / $380.19	Professional		$158.49	$302.00	$380.19
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $457.09 / $457.09	Professional	50	$407.38	$457.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $239.88 / $269.15	Facility		$199.53	$239.88	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $239.88	Professional		$218.78	$218.78	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $446.68 / $691.83	Professional		$173.78	$446.68	$691.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,412.54 / $4,897.79	Facility		$338.84	$1,412.54	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $3,467.37 / $5,128.61 / $5,128.61	Facility	50	$3,467.37	$5,128.61	$5,128.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $851.14	Professional		$245.47	$426.58	$851.14
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $660.69 / $1,659.59 / $2,691.53	Professional	50	$660.69	$1,659.59	$2,691.53
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $575.44	Professional		$190.55	$407.38	$575.44
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 $288.40 / $549.54 / $707.95	Professional		$288.40	$549.54	$707.95