Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.99 / $302.32 / $2,056.00	Facility		$175.99	$302.32	$2,056.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $226.75 / $362.78	Professional		$135.00	$226.75	$362.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $256.19 / $357.35 / $357.35	Professional		$256.19	$357.35	$357.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $544.87 / $635.57 / $894.20	Facility		$544.87	$635.57	$894.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $151.56 / $242.27	Professional		$28.98	$151.56	$242.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.37 / $155.51 / $209.98	Facility		$141.37	$155.51	$209.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $246.61 / $262.05 / $390.55	Professional		$246.61	$262.05	$390.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.85 / $238.07 / $641.67	Professional		$149.85	$238.07	$641.67
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $175.99 / $302.32 / $4,933.00	Facility		$175.99	$302.32	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $175.99 / $234.21 / $380.92	Professional		$175.99	$234.21	$380.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $215.60 / $319.74	Professional		$31.89	$215.60	$319.74
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 $219.95 / $265.60 / $365.19	Professional		$219.95	$265.60	$365.19