Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.30 / $87.88 / $125.86	Facility		$70.30	$87.88	$125.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.19 / $84.15 / $235.57	Professional		$52.19	$84.15	$235.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.75 / $96.18 / $118.01	Professional		$81.75	$96.18	$118.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.40 / $146.40 / $655.86	Facility		$146.40	$146.40	$655.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.09 / $153.72 / $183.00	Professional		$133.09	$153.72	$183.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.57 / $79.98 / $95.36	Facility		$62.57	$79.98	$95.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.66 / $118.12 / $183.67	Professional		$94.66	$118.12	$183.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.07 / $91.49 / $264.08	Professional		$57.07	$91.49	$264.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.73 / $94.54 / $125.86	Facility		$70.73	$94.54	$125.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $97.68 / $175.23	Professional		$69.50	$97.68	$175.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $98.74 / $100.00	Professional		$55.00	$98.74	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $82.74 / $102.13 / $134.01	Professional		$82.74	$102.13	$134.01