Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.01 / $76.02 / $76.02	Facility		$57.01	$76.02	$76.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $64.65 / $90.99	Professional		$57.01	$64.65	$90.99
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.36 / $59.36 / $59.36	Professional	25	$59.36	$59.36	$59.36
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $62.40 / $62.40 / $62.40	Professional	25	$62.40	$62.40	$62.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.42 / $110.55 / $257.77	Facility		$93.42	$110.55	$257.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.42 / $110.55 / $122.97	Professional		$93.42	$110.55	$122.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $95.90 / $95.90	Facility		$95.90	$95.90	$95.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.79 / $98.16 / $176.40	Professional		$56.79	$98.16	$176.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $64.61 / $76.02 / $76.02	Facility		$64.61	$76.02	$76.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $72.38 / $107.04	Professional		$57.01	$72.38	$107.04
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $59.36 / $59.36 / $59.36	Professional	25	$59.36	$59.36	$59.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.48 / $66.62 / $78.71	Professional		$60.48	$66.62	$78.71
United Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $73.11 / $98.74	Professional		$57.69	$73.11	$98.74