Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.32 / $689.36 / $5,942.75	Facility		$173.32	$689.36	$5,942.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $172.86 / $304.00	Professional		$87.03	$172.86	$304.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.96 / $91.80 / $99.03	Professional		$82.96	$91.80	$99.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $943.85 / $1,100.08 / $1,490.44	Facility		$943.85	$1,100.08	$1,490.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $118.00 / $192.02	Professional		$28.98	$118.00	$192.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.07 / $155.18 / $209.53	Facility		$141.07	$155.18	$209.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $187.67 / $201.95 / $300.27	Professional		$187.67	$201.95	$300.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $182.49 / $637.36	Professional		$129.74	$182.49	$637.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $181.98 / $1,255.88 / $5,942.75	Facility		$181.98	$1,255.88	$5,942.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $119.12 / $189.45 / $301.30	Professional		$119.12	$189.45	$301.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.56 / $170.59 / $241.73	Professional		$123.56	$170.59	$241.73
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,594.00	Facility		$773.00	$3,005.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.18 / $213.06 / $310.30	Professional		$179.18	$213.06	$310.30