Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.58 / $2,431.17 / $5,648.10	Facility		$181.58	$2,431.17	$5,648.10
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $83.27 / $86.47 / $160.24	Facility	52	$83.27	$86.47	$160.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.34 / $245.57 / $377.79	Professional		$130.34	$245.57	$377.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $132.63 / $187.01	Professional		$124.67	$132.63	$187.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,294.45 / $3,845.62 / $5,238.79	Facility		$3,294.45	$3,845.62	$5,238.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.51 / $148.32 / $288.04	Professional		$32.51	$148.32	$288.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.35 / $166.52 / $183.21	Facility		$123.35	$166.52	$183.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $237.89 / $283.20 / $300.74	Professional		$237.89	$283.20	$300.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.56 / $228.22 / $391.36	Professional		$134.56	$228.22	$391.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $308.61 / $2,523.69 / $5,648.10	Facility		$308.61	$2,523.69	$5,648.10
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $83.27 / $83.27 / $154.31	Facility	52	$83.27	$83.27	$154.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $166.53 / $308.61 / $431.07	Professional		$166.53	$308.61	$431.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.54 / $272.95 / $390.71	Professional		$219.54	$272.95	$390.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $277.68 / $348.12 / $497.98	Professional		$277.68	$348.12	$497.98