Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.54 / $265.05 / $715.55	Facility		$121.54	$265.05	$715.55
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $91.16 / $91.16 / $108.38	Facility	54	$91.16	$91.16	$108.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.85 / $129.59 / $248.90	Professional		$86.85	$129.59	$248.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $107.29 / $176.66	Professional		$91.02	$107.29	$176.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $340.48 / $396.85 / $537.66	Facility		$340.48	$396.85	$537.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $82.70 / $159.04	Professional		$21.48	$82.70	$159.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.50 / $109.45 / $147.78	Facility		$99.50	$109.45	$147.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $129.55 / $192.99	Professional		$121.55	$129.55	$192.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.98 / $125.93 / $460.40	Professional		$93.98	$125.93	$460.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $121.54 / $270.75 / $2,007.72	Facility		$121.54	$270.75	$2,007.72
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $91.16 / $91.16 / $108.38	Facility	54	$91.16	$91.16	$108.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $98.02 / $139.77 / $221.00	Professional		$98.02	$139.77	$221.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $101.32 / $141.24	Professional		$81.79	$101.32	$141.24
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,209.00 / $2,029.00	Facility		$464.00	$1,209.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.53 / $129.72 / $187.70	Professional		$105.53	$129.72	$187.70