Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $174.81 / $174.81	Facility		$174.81	$174.81	$174.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $262.22	Professional		$174.81	$174.81	$262.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $246.89 / $470.03	Professional		$107.62	$246.89	$470.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.46 / $346.25 / $592.77	Facility		$244.46	$346.25	$592.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.32 / $230.24 / $296.02	Professional		$208.32	$230.24	$296.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.79 / $125.75 / $155.49	Facility		$104.79	$125.75	$155.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $136.22 / $172.58	Professional		$104.87	$136.22	$172.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $202.44 / $238.66	Professional		$102.95	$202.44	$238.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $550.65 / $1,274.83	Facility		$174.81	$550.65	$1,274.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $209.77 / $1,040.03	Professional		$141.69	$209.77	$1,040.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $311.76 / $386.34 / $598.04	Professional		$311.76	$386.34	$598.04