Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.59 / $464.59 / $464.59	Facility		$464.59	$464.59	$464.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.99 / $464.59 / $692.02	Professional		$351.99	$464.59	$692.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $757.54 / $757.54 / $757.54	Professional		$757.54	$757.54	$757.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $997.73 / $1,987.85 / $3,620.54	Facility		$997.73	$1,987.85	$3,620.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $626.23 / $659.19 / $889.91	Professional		$626.23	$659.19	$889.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $428.47 / $428.47 / $504.74	Facility		$428.47	$428.47	$504.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $527.35 / $527.35 / $527.35	Professional		$527.35	$527.35	$527.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $758.68 / $758.68	Facility		$758.68	$758.68	$758.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.68 / $758.68 / $1,028.43	Professional		$758.68	$758.68	$1,028.43
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $464.59 / $663.05 / $663.05	Facility		$464.59	$663.05	$663.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $464.59 / $663.05 / $823.98	Professional		$464.59	$663.05	$823.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $633.20 / $744.95 / $856.69	Professional		$633.20	$744.95	$856.69
United Facility/Professional Professional Modifier Low / Median / High Price $459.49 / $580.84 / $968.06	Professional		$459.49	$580.84	$968.06