Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $69.18 / $2,041.74	Facility		$41.69	$69.18	$2,041.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $74.13 / $363.08 / $8,912.51	Facility	50	$74.13	$363.08	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $56.23 / $134.90	Professional		$30.20	$56.23	$134.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $102.33 / $302.00	Professional	50	$52.48	$102.33	$302.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.92 / $42.66 / $151.36	Professional	52	$26.92	$42.66	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $58.88	Professional		$34.67	$44.67	$58.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $69.18 / $95.50	Professional	50	$54.95	$69.18	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $56.23 / $56.23	Facility		$35.48	$56.23	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $50.12 / $53.70	Professional		$35.48	$50.12	$53.70
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $60.26 / $91.20	Professional	50	$60.26	$60.26	$91.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $74.13	Professional		$33.88	$47.86	$74.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $69.18 / $2,041.74	Facility		$38.90	$69.18	$2,041.74
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $74.13 / $204.17 / $2,754.23	Facility	50	$74.13	$204.17	$2,754.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $109.65	Professional		$33.11	$54.95	$109.65
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $100.00 / $234.42	Professional	50	$47.86	$100.00	$234.42
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $27.54 / $41.69 / $151.36	Professional	52	$27.54	$41.69	$151.36
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $74.13	Professional		$35.48	$51.29	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $831.76 / $1,862.09	Facility		$46.77	$831.76	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $72.44	Professional		$36.31	$51.29	$72.44