Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.53 / $2,419.98 / $2,959.64	Facility		$426.53	$2,419.98	$2,959.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.66 / $426.53 / $426.53	Professional		$369.66	$426.53	$426.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $560.15 / $560.15 / $746.86	Professional		$560.15	$560.15	$746.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,130.42 / $2,252.23 / $4,102.05	Facility		$1,130.42	$2,252.23	$4,102.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.52 / $746.86 / $1,008.26	Professional		$709.52	$746.86	$1,008.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $405.90 / $432.99 / $485.46	Facility		$405.90	$432.99	$485.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $597.49 / $597.49 / $597.49	Professional		$597.49	$597.49	$597.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $523.66 / $523.66 / $523.66	Facility		$523.66	$523.66	$523.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.28 / $621.01 / $1,082.33	Professional		$382.28	$621.01	$1,082.33
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $539.71 / $2,419.98 / $2,959.64	Facility		$539.71	$2,419.98	$2,959.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $401.14 / $539.71 / $896.23	Professional		$401.14	$539.71	$896.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $453.19 / $552.67 / $635.58	Professional		$453.19	$552.67	$635.58
United Facility/Professional Professional Modifier Low / Median / High Price $248.40 / $350.72 / $534.53	Professional		$248.40	$350.72	$534.53