Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.52 / $354.52 / $354.52	Facility		$354.52	$354.52	$354.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.02 / $300.08 / $354.52	Professional		$244.02	$300.08	$354.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $373.30 / $373.30 / $373.30	Professional		$373.30	$373.30	$373.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,675.88 / $1,675.88 / $2,194.60	Facility		$1,675.88	$1,675.88	$2,194.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $434.13 / $456.98 / $616.91	Professional		$434.13	$456.98	$616.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.71 / $246.04 / $328.04	Facility		$29.71	$246.04	$328.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $274.19 / $403.74	Professional		$36.56	$274.19	$403.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.50 / $229.50 / $229.50	Facility		$229.50	$229.50	$229.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.50 / $277.60 / $393.05	Professional		$229.50	$277.60	$393.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.32 / $354.52 / $504.67	Professional		$194.32	$354.52	$504.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $129.08 / $277.60	Professional		$22.75	$129.08	$277.60
United Facility/Professional Professional Modifier Low / Median / High Price $169.63 / $248.70 / $399.06	Professional		$169.63	$248.70	$399.06