Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.20 / $259.20 / $1,849.62	Facility		$187.20	$259.20	$1,849.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $160.13 / $160.13 / $185.15	Facility	54	$160.13	$160.13	$185.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $213.52 / $340.17	Professional		$144.28	$213.52	$340.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.77 / $213.85 / $278.01	Professional		$181.77	$213.85	$278.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $544.87 / $744.79 / $1,717.54	Facility		$544.87	$744.79	$1,717.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $195.97 / $270.48	Professional		$33.32	$195.97	$270.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.08 / $206.50 / $290.58	Facility		$172.08	$206.50	$290.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.70 / $219.31 / $326.10	Professional		$203.70	$219.31	$326.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.58 / $221.54 / $779.80	Professional		$164.58	$221.54	$779.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.91 / $251.30 / $2,056.00	Facility		$169.91	$251.30	$2,056.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $160.13 / $160.13 / $185.15	Facility	54	$160.13	$160.13	$185.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $166.78 / $224.19 / $325.85	Professional		$166.78	$224.19	$325.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.02 / $185.86 / $259.82	Professional		$149.02	$185.86	$259.82
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $190.97 / $227.22 / $286.55	Professional		$190.97	$227.22	$286.55