Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.56 / $46.56 / $46.56	Facility		$46.56	$46.56	$46.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $46.56 / $46.56	Professional		$37.45	$46.56	$46.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.15 / $61.15 / $61.15	Professional		$61.15	$61.15	$61.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.40 / $245.86 / $447.80	Facility		$123.40	$245.86	$447.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.45 / $81.53 / $110.07	Professional		$77.45	$81.53	$110.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.46 / $49.50 / $52.99	Facility		$44.46	$49.50	$52.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.22 / $65.22 / $65.22	Professional		$65.22	$65.22	$65.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $36.72 / $36.72	Facility		$36.72	$36.72	$36.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $36.72 / $94.50	Professional		$36.72	$36.72	$94.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $46.56 / $58.93 / $58.93	Facility		$46.56	$58.93	$58.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.08 / $58.93 / $85.60	Professional		$44.08	$58.93	$85.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.47 / $60.33 / $69.37	Professional		$49.47	$60.33	$69.37
United Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $37.61 / $54.75	Professional		$27.12	$37.61	$54.75