Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $1,258.93 / $4,897.79	Facility		$208.93	$1,258.93	$4,897.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	50	$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $537.03	Professional		$123.03	$213.80	$537.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $436.52 / $831.76	Professional	50	$295.12	$436.52	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $223.87	Professional		$134.90	$169.82	$223.87
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $354.81 / $562.34	Professional	50	$354.81	$354.81	$562.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $100.00 / $141.25	Facility		$26.92	$100.00	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $169.82 / $251.19	Professional		$31.62	$169.82	$251.19
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $213.80 / $251.19 / $380.19	Professional	50	$213.80	$251.19	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $309.03	Professional		$123.03	$199.53	$309.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $1,023.29 / $4,897.79	Facility		$208.93	$1,023.29	$4,897.79
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	50	$549.54	$549.54	$549.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $229.09 / $389.05	Professional		$141.25	$229.09	$389.05
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $426.58 / $831.76	Professional	50	$295.12	$426.58	$831.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $302.00	Professional		$138.04	$199.53	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,148.15 / $1,862.09	Facility		$398.11	$1,148.15	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $281.84	Professional		$141.25	$204.17	$281.84