Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.42 / $840.80 / $4,533.08	Facility		$247.42	$840.80	$4,533.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.71 / $259.79 / $646.21	Professional		$188.71	$259.79	$646.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.17 / $197.07 / $333.01	Professional		$123.17	$197.07	$333.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,461.65 / $2,161.05 / $2,983.55	Facility		$1,461.65	$2,161.05	$2,983.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $200.79 / $346.60	Professional		$51.06	$200.79	$346.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $182.60 / $228.35 / $275.64	Facility		$182.60	$228.35	$275.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $455.93 / $573.47 / $811.85	Professional		$455.93	$573.47	$811.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.58 / $400.74 / $942.29	Professional		$207.58	$400.74	$942.29
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $247.41 / $861.00 / $4,933.00	Facility		$247.41	$861.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $199.93 / $340.60 / $711.16	Professional		$199.93	$340.60	$711.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $380.24 / $471.70 / $679.25	Professional		$380.24	$471.70	$679.25
United Facility/Professional Facility Modifier Low / Median / High Price $585.48 / $3,569.00 / $6,029.00	Facility		$585.48	$3,569.00	$6,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $274.35 / $539.11 / $784.16	Professional		$274.35	$539.11	$784.16