Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.22 / $312.36 / $875.35	Facility		$161.22	$312.36	$875.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.31 / $109.81 / $211.84	Professional		$69.31	$109.81	$211.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.73 / $75.61 / $107.29	Professional		$55.73	$75.61	$107.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.18 / $303.70 / $413.74	Facility		$260.18	$303.70	$413.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.95 / $51.29 / $110.79	Professional		$13.95	$51.29	$110.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.89 / $87.60 / $96.39	Facility		$64.89	$87.60	$96.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $143.10 / $151.88	Professional		$120.20	$143.10	$151.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.72 / $117.12 / $193.48	Professional		$68.72	$117.12	$193.48
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $166.74 / $273.20 / $875.35	Facility		$166.74	$273.20	$875.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $117.50 / $212.81	Professional		$70.63	$117.50	$212.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $136.45 / $195.19	Professional		$108.90	$136.45	$195.19
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $121.33 / $146.08 / $201.52	Professional		$121.33	$146.08	$201.52