Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.16 / $210.55 / $2,878.00	Facility		$26.16	$210.55	$2,878.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $50.90 / $102.00	Professional		$24.76	$50.90	$102.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.14 / $18.93 / $27.07	Professional		$11.14	$18.93	$27.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $120.58 / $169.65	Facility		$102.94	$120.58	$169.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.59 / $29.88 / $44.37	Professional		$5.59	$29.88	$44.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.05 / $25.26 / $80.01	Facility		$21.05	$25.26	$80.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.14 / $81.05 / $121.05	Professional		$77.14	$81.05	$121.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $54.01 / $119.37	Professional		$19.84	$54.01	$119.37
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.43 / $140.11 / $4,933.00	Facility		$54.43	$140.11	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.16 / $54.46 / $104.35	Professional		$26.16	$54.46	$104.35
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 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $69.43 / $92.61	Professional		$58.84	$69.43	$92.61