Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $42.87 / $99.99	Facility		$15.49	$42.87	$99.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.23 / $14.68 / $32.60	Professional		$12.23	$14.68	$32.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $6.52 / $8.15 / $42.13	Professional		$6.52	$8.15	$42.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.81 / $18.45 / $32.40	Facility		$12.81	$18.45	$32.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $12.23 / $16.51	Professional		$8.32	$12.23	$16.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.23 / $16.30 / $44.26	Facility		$12.23	$16.30	$44.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.60 / $10.60 / $16.30	Professional		$10.60	$10.60	$16.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.54 / $18.59 / $23.23	Professional		$12.54	$18.59	$23.23
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $31.51 / $112.50	Facility		$15.49	$31.51	$112.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $14.02 / $16.30 / $32.60	Professional		$14.02	$16.30	$32.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.15 / $13.50 / $18.22	Professional		$12.15	$13.50	$18.22
United Facility/Professional Professional Modifier Low / Median / High Price $6.85 / $13.42 / $14.14	Professional		$6.85	$13.42	$14.14