Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.88 / $239.35 / $3,638.10	Facility		$121.88	$239.35	$3,638.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $128.66 / $250.93	Professional		$82.89	$128.66	$250.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.34 / $149.34 / $149.34	Professional		$149.34	$149.34	$149.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $542.58 / $632.40 / $856.80	Facility		$542.58	$632.40	$856.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.28 / $165.72 / $255.76	Professional		$30.28	$165.72	$255.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.40 / $108.24 / $146.15	Facility		$98.40	$108.24	$146.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.47 / $152.75 / $227.57	Professional		$143.47	$152.75	$227.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.39 / $144.02 / $453.20	Professional		$92.39	$144.02	$453.20
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $121.88 / $187.20 / $4,933.00	Facility		$121.88	$187.20	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $116.60 / $156.49 / $232.79	Professional		$116.60	$156.49	$232.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $134.77 / $188.01	Professional		$108.90	$134.77	$188.01
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $116.60 / $155.55 / $205.69	Professional		$116.60	$155.55	$205.69