Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $249.34 / $322.22	Facility		$68.48	$249.34	$322.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $71.19 / $158.19	Professional		$40.14	$71.19	$158.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.12 / $93.50 / $103.54	Professional		$70.12	$93.50	$103.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.68 / $375.92 / $684.68	Facility		$188.68	$375.92	$684.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.43 / $124.66 / $168.29	Professional		$118.43	$124.66	$168.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.03 / $124.66 / $189.50	Facility		$81.03	$124.66	$189.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.73 / $162.06 / $221.09	Professional		$99.73	$162.06	$221.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.64 / $86.64 / $91.83	Facility		$86.64	$86.64	$91.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.64 / $86.64 / $144.38	Professional		$86.64	$86.64	$144.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $247.46 / $322.22	Facility		$68.48	$247.46	$322.22
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $89.22 / $143.35	Professional		$44.16	$89.22	$143.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.64 / $92.25 / $106.08	Professional		$75.64	$92.25	$106.08
United Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $62.19 / $89.22	Professional		$48.70	$62.19	$89.22