Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,266.79 / $4,222.12 / $7,477.72	Facility		$1,266.79	$4,222.12	$7,477.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $87.90 / $91.16 / $262.74	Facility	53	$87.90	$91.16	$262.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.72 / $886.38 / $1,354.00	Professional		$320.72	$886.38	$1,354.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.80 / $440.44 / $522.48	Professional		$338.80	$440.44	$522.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,320.63 / $3,870.31 / $5,243.65	Facility		$3,320.63	$3,870.31	$5,243.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.30 / $524.08 / $992.28	Professional		$83.30	$524.08	$992.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $310.26 / $418.85 / $460.81	Facility		$310.26	$418.85	$460.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $872.85 / $872.85 / $1,039.10	Professional		$872.85	$872.85	$1,039.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $351.11 / $676.28 / $1,752.25	Professional		$351.11	$676.28	$1,752.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,192.88 / $4,112.00 / $7,902.40	Facility		$1,192.88	$4,112.00	$7,902.40
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $87.90 / $87.90 / $253.36	Facility	53	$87.90	$87.90	$253.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $439.50 / $1,141.81 / $1,646.82	Professional		$439.50	$1,141.81	$1,646.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.63 / $795.01 / $1,190.94	Professional		$98.63	$795.01	$1,190.94
United Facility/Professional Facility Modifier Low / Median / High Price $3,054.00 / $6,649.00 / $9,202.00	Facility		$3,054.00	$6,649.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,192.57 / $1,546.58 / $1,941.11	Professional		$1,192.57	$1,546.58	$1,941.11