Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $151.36	Professional		$125.89	$125.89	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $204.17 / $371.54	Facility		$97.72	$204.17	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $177.83	Professional		$144.54	$154.88	$177.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $128.82 / $169.82	Facility		$52.48	$128.82	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $104.71 / $131.83	Professional		$30.20	$104.71	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $177.83	Professional		$147.91	$147.91	$177.83