Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.23 / $141.21 / $4,933.00	Facility		$58.23	$141.21	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.39 / $84.55 / $169.45	Professional		$48.39	$84.55	$169.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.15 / $71.15 / $99.93	Professional		$71.15	$71.15	$99.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.19 / $168.05 / $227.69	Facility		$144.19	$168.05	$227.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.19 / $49.52 / $76.87	Professional		$9.19	$49.52	$76.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $50.39 / $68.03	Facility		$45.81	$50.39	$68.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.40 / $120.80 / $180.27	Professional		$114.40	$120.80	$180.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $95.23 / $241.33	Professional		$42.79	$95.23	$241.33
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $73.36 / $183.67 / $4,933.00	Facility		$73.36	$183.67	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $94.40 / $179.86	Professional		$58.22	$94.40	$179.86
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 $96.48 / $127.06 / $169.04	Professional		$96.48	$127.06	$169.04