Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.98 / $730.84 / $4,933.00	Facility		$372.98	$730.84	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.27 / $547.00 / $777.59	Professional		$312.27	$547.00	$777.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $629.70 / $629.70 / $763.20	Professional		$629.70	$629.70	$763.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $672.79 / $784.16 / $1,062.42	Facility		$672.79	$784.16	$1,062.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $450.38 / $888.90	Professional		$80.59	$450.38	$888.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $298.87 / $328.76 / $443.90	Facility		$298.87	$328.76	$443.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $607.53 / $645.79 / $962.48	Professional		$607.53	$645.79	$962.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.37 / $550.55 / $1,322.20	Professional		$276.37	$550.55	$1,322.20
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $469.95 / $951.21 / $4,933.00	Facility		$469.95	$951.21	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $372.98 / $601.85 / $877.00	Professional		$372.98	$601.85	$877.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $545.60 / $675.34 / $936.36	Professional		$545.60	$675.34	$936.36
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 $573.61 / $673.04 / $891.43	Professional		$573.61	$673.04	$891.43