Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $4,897.79 / $4,897.79	Facility		$100.00	$4,897.79	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $186.21	Professional		$77.62	$104.71	$186.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $147.91 / $660.69	Professional	50	$147.91	$147.91	$660.69
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	50	$138.04	$138.04	$138.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $138.04 / $138.04	Facility		$14.13	$138.04	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $138.04	Professional		$93.33	$120.23	$138.04
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $147.91 / $177.83	Professional	50	$147.91	$147.91	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $204.17	Professional		$63.10	$93.33	$204.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $354.81 / $4,897.79	Facility		$123.03	$354.81	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $173.78	Professional		$89.13	$120.23	$173.78
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $169.82 / $239.88	Professional	50	$109.65	$169.82	$239.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $125.89	Professional		$67.61	$83.18	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $1,000.00 / $1,737.80	Facility		$316.23	$1,000.00	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $154.88	Professional		$87.10	$117.49	$154.88