Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.45 / $607.87 / $3,515.73	Facility		$92.45	$607.87	$3,515.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.43 / $110.26 / $192.46	Professional		$60.43	$110.26	$192.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.47 / $65.47 / $78.56	Professional		$65.47	$65.47	$78.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $813.53 / $1,098.53 / $2,579.76	Facility		$813.53	$1,098.53	$2,579.76
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $435.93 / $594.82 / $871.03	Facility	50	$435.93	$594.82	$871.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.61 / $74.45 / $167.80	Professional		$17.61	$74.45	$167.80
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $166.17 / $270.95 / $318.77	Professional	50	$166.17	$270.95	$318.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.12 / $83.34 / $100.01	Facility		$66.12	$83.34	$100.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $159.90 / $247.06	Professional		$120.94	$159.90	$247.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.95 / $105.91 / $194.85	Professional		$60.95	$105.91	$194.85
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $92.45 / $603.66 / $4,678.92	Facility		$92.45	$603.66	$4,678.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $122.21 / $214.17	Professional		$87.00	$122.21	$214.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $135.99 / $193.70	Professional		$109.37	$135.99	$193.70
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $117.18 / $143.94 / $189.37	Professional		$117.18	$143.94	$189.37