Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.65 / $92.65 / $92.65	Facility		$92.65	$92.65	$92.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.25 / $30.94	Professional		$22.91	$26.25	$30.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.31 / $15.97 / $35.92	Professional		$13.31	$15.97	$35.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.96 / $20.76 / $26.95	Professional		$18.96	$20.76	$26.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.61 / $39.52 / $63.86	Facility		$26.61	$39.52	$63.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $29.27 / $35.92	Professional		$26.61	$29.27	$35.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $32.63 / $59.87	Professional		$13.54	$32.63	$59.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $24.02 / $24.02 / $46.45	Facility		$24.02	$24.02	$46.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.65 / $40.70	Professional		$22.91	$26.65	$40.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $24.23 / $39.65	Professional		$22.03	$24.23	$39.65
United Facility/Professional Professional Modifier Low / Median / High Price $15.97 / $36.82 / $103.21	Professional		$15.97	$36.82	$103.21