Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.65 / $170.19 / $2,056.00	Facility		$0.65	$170.19	$2,056.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $50.95 / $102.06	Professional		$21.03	$50.95	$102.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $48.36 / $58.57	Professional		$41.11	$48.36	$58.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.94 / $277.68 / $658.11	Facility		$202.94	$277.68	$658.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.58 / $21.74 / $31.91	Professional		$4.58	$21.74	$31.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.41 / $22.45 / $30.31	Facility		$20.41	$22.45	$30.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $49.56 / $73.88	Professional		$46.76	$49.56	$73.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $43.13 / $107.82	Professional		$19.02	$43.13	$107.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $0.65 / $115.13 / $4,933.00	Facility		$0.65	$115.13	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $53.03 / $102.06	Professional		$25.35	$53.03	$102.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $33.62 / $47.36	Professional		$27.09	$33.62	$47.36
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 $49.05 / $60.83 / $80.78	Professional		$49.05	$60.83	$80.78