Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.13 / $879.30 / $4,933.00	Facility		$30.13	$879.30	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.57 / $30.13 / $61.28	Professional		$15.57	$30.13	$61.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $33.90	Professional		$21.70	$21.70	$33.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.86 / $260.89 / $601.62	Facility		$190.86	$260.89	$601.62
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $102.39 / $138.96 / $203.49	Facility	50	$102.39	$138.96	$203.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.26 / $33.50 / $49.75	Professional		$6.26	$33.50	$49.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.52 / $25.87 / $34.94	Facility		$23.52	$25.87	$34.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $40.81 / $60.58	Professional		$37.54	$40.81	$60.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $35.75 / $99.27	Professional		$21.26	$35.75	$99.27
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $454.17 / $4,643.14	Facility		$30.67	$454.17	$4,643.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $42.05 / $58.50	Professional		$26.66	$42.05	$58.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $67.87 / $95.12	Professional		$54.90	$67.87	$95.12
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 $36.51 / $45.42 / $61.74	Professional		$36.51	$45.42	$61.74