Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.32 / $230.32 / $230.32	Facility		$230.32	$230.32	$230.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.01 / $230.32 / $230.32	Professional		$196.01	$230.32	$230.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.47 / $302.47 / $302.47	Professional		$302.47	$302.47	$302.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $610.41 / $1,216.16 / $2,215.03	Facility		$610.41	$1,216.16	$2,215.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.13 / $403.29 / $544.44	Professional		$383.13	$403.29	$544.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $262.14 / $262.14 / $349.52	Facility		$262.14	$262.14	$349.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $322.63 / $322.63 / $322.63	Professional		$322.63	$322.63	$322.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.88 / $260.88 / $260.88	Facility		$260.88	$260.88	$260.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.88 / $260.88 / $467.63	Professional		$260.88	$260.88	$467.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $230.32 / $291.44 / $291.44	Facility		$230.32	$291.44	$291.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $228.19 / $291.44 / $453.60	Professional		$228.19	$291.44	$453.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $253.66 / $298.43 / $343.19	Professional		$253.66	$298.43	$343.19
United Facility/Professional Professional Modifier Low / Median / High Price $167.67 / $201.20 / $310.04	Professional		$167.67	$201.20	$310.04