Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.85 / $754.24 / $2,056.00	Facility		$391.85	$754.24	$2,056.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,229.57 / $1,229.57 / $6,713.70	Facility	50	$1,229.57	$1,229.57	$6,713.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.96 / $859.37 / $1,267.68	Professional		$336.96	$859.37	$1,267.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $274.54 / $331.87 / $577.65	Professional		$274.54	$331.87	$577.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $446.61 / $446.61 / $866.47	Professional	50	$446.61	$446.61	$866.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $810.33 / $944.47 / $1,279.60	Facility		$810.33	$944.47	$1,279.60
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $436.58 / $721.75 / $867.61	Facility	50	$436.58	$721.75	$867.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.11 / $320.57 / $530.15	Professional		$64.11	$320.57	$530.15
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $567.00 / $567.00 / $634.41	Professional	50	$567.00	$567.00	$634.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $279.23 / $351.01 / $382.45	Facility		$279.23	$351.01	$382.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $306.45 / $310.76 / $403.99	Professional		$306.45	$310.76	$403.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.66 / $665.97 / $1,036.60	Professional		$266.66	$665.97	$1,036.60
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $107.50 / $1,085.43 / $4,933.00	Facility		$107.50	$1,085.43	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $1,229.57 / $6,713.70 / $6,713.70	Facility	50	$1,229.57	$6,713.70	$6,713.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $370.54 / $740.00 / $1,276.43	Professional		$370.54	$740.00	$1,276.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $256.74 / $365.06	Professional		$30.79	$256.74	$365.06
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $2,800.00 / $4,594.00	Facility		$645.00	$2,800.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $380.29 / $710.64 / $1,455.68	Professional		$380.29	$710.64	$1,455.68