Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.97 / $215.82 / $502.64	Facility		$54.97	$215.82	$502.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $97.79 / $127.22	Professional		$87.73	$97.79	$127.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $136.97 / $171.23	Professional		$76.37	$136.97	$171.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.17 / $516.36 / $940.46	Facility		$259.17	$516.36	$940.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.66 / $171.23 / $231.16	Professional		$162.66	$171.23	$231.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.95 / $171.23 / $254.32	Facility		$94.95	$171.23	$254.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $136.97 / $204.50 / $239.72	Professional		$136.97	$204.50	$239.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $96.73 / $96.73	Facility		$95.80	$96.73	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $96.73 / $198.38	Professional		$95.80	$96.73	$198.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.97 / $205.49 / $502.64	Facility		$54.97	$205.49	$502.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $123.74 / $171.23	Professional		$87.73	$123.74	$171.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $126.71 / $145.71	Professional		$103.90	$126.71	$145.71
United Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $78.98 / $115.58	Professional		$60.73	$78.98	$115.58