Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.04 / $79.84 / $196.19	Facility		$76.04	$79.84	$196.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $70.86 / $98.09	Professional		$49.11	$70.86	$98.09
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $57.12 / $57.12 / $57.12	Professional	CQ	$57.12	$57.12	$57.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.04 / $87.04 / $87.04	Professional		$87.04	$87.04	$87.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $127.08 / $157.19	Facility		$70.00	$127.08	$157.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $83.37 / $95.00	Professional		$43.00	$83.37	$95.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.44 / $93.88 / $130.88	Facility		$78.44	$93.88	$130.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.69 / $107.74 / $122.04	Professional		$93.69	$107.74	$122.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $65.00 / $65.00	Facility		$53.50	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.89 / $83.82 / $134.53	Professional		$60.89	$83.82	$134.53
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $76.04 / $78.44 / $196.19	Facility		$76.04	$78.44	$196.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $58.45 / $76.37 / $111.37	Professional		$58.45	$76.37	$111.37
Health Alliance Plan Facility/Professional Professional Modifier CQ Low / Median / High Price $57.12 / $57.12 / $57.12	Professional	CQ	$57.12	$57.12	$57.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $100.04 / $140.27	Professional		$81.30	$100.04	$140.27
United Facility/Professional Professional Modifier Low / Median / High Price $70.55 / $78.93 / $91.67	Professional		$70.55	$78.93	$91.67