Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.70 / $162.44 / $198.67	Facility		$64.70	$162.44	$198.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $64.70 / $73.43	Professional		$36.50	$64.70	$73.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $84.98 / $84.98	Professional		$79.56	$84.98	$84.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.50 / $341.70 / $622.34	Facility		$171.50	$341.70	$622.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.64 / $113.31 / $152.97	Professional		$107.64	$113.31	$152.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.65 / $113.31 / $168.29	Facility		$73.65	$113.31	$168.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.65 / $147.30 / $158.63	Professional		$90.65	$147.30	$158.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.80 / $70.80 / $74.27	Facility		$70.80	$70.80	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.68 / $94.21 / $164.06	Professional		$51.68	$94.21	$164.06
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.88 / $162.44 / $198.67	Facility		$81.88	$162.44	$198.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.87 / $81.88 / $127.64	Professional		$44.87	$81.88	$127.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $83.85 / $96.42	Professional		$68.75	$83.85	$96.42
United Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $56.02 / $81.09	Professional		$44.26	$56.02	$81.09