Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.06 / $115.63 / $4,933.00	Facility		$40.06	$115.63	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $59.96 / $143.77	Professional		$26.69	$59.96	$143.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $95.84 / $95.84	Professional		$81.45	$95.84	$95.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.95 / $220.23 / $298.38	Facility		$188.95	$220.23	$298.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $34.10 / $53.54	Professional		$6.74	$34.10	$53.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.73 / $34.90 / $47.12	Facility		$31.73	$34.90	$47.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.07 / $98.09 / $146.38	Professional		$93.07	$98.09	$146.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $69.70 / $168.93	Professional		$29.50	$69.70	$168.93
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $50.47 / $305.37 / $4,933.00	Facility		$50.47	$305.37	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $75.22 / $146.63	Professional		$40.06	$75.22	$146.63
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 $70.28 / $102.49 / $136.31	Professional		$70.28	$102.49	$136.31