Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.33 / $67.33 / $67.33	Facility		$67.33	$67.33	$67.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $63.32 / $69.58	Professional		$58.35	$63.32	$69.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.42 / $88.42 / $88.42	Professional		$88.42	$88.42	$88.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.43 / $355.51 / $647.50	Facility		$178.43	$355.51	$647.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $117.89 / $159.15	Professional		$112.00	$117.89	$159.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.80 / $76.63 / $77.06	Facility		$74.80	$76.63	$77.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $94.31 / $94.31	Professional		$94.31	$94.31	$94.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $65.81 / $383.66	Facility		$65.81	$65.81	$383.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $65.81 / $136.50	Professional		$65.81	$65.81	$136.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.33 / $85.20 / $85.20	Facility		$67.33	$85.20	$85.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $85.20 / $120.24	Professional		$63.25	$85.20	$120.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $87.24 / $100.32	Professional		$71.53	$87.24	$100.32
United Facility/Professional Facility Modifier Low / Median / High Price $119.37 / $140.44 / $140.44	Facility		$119.37	$140.44	$140.44
United Facility/Professional Professional Modifier Low / Median / High Price $41.14 / $55.37 / $87.58	Professional		$41.14	$55.37	$87.58