Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.24 / $139.88 / $4,933.00	Facility		$60.24	$139.88	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $82.89 / $198.89	Professional		$45.71	$82.89	$198.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.76 / $99.76 / $99.76	Professional		$99.76	$99.76	$99.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.79 / $208.38 / $282.32	Facility		$178.79	$208.38	$282.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $33.61 / $81.65	Professional		$9.77	$33.61	$81.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.37 / $58.04 / $135.88	Facility		$48.37	$58.04	$135.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.32 / $120.15 / $179.13	Professional		$113.32	$120.15	$179.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.44 / $92.68 / $244.10	Professional		$44.44	$92.68	$244.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $92.44 / $250.26 / $4,933.00	Facility		$92.44	$250.26	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.24 / $101.94 / $191.64	Professional		$60.24	$101.94	$191.64
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 $72.78 / $118.28 / $158.25	Professional		$72.78	$118.28	$158.25