Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $133.60 / $4,933.00	Facility		$53.95	$133.60	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $73.73 / $160.31	Professional		$38.90	$73.73	$160.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $144.41 / $144.41	Professional		$47.21	$144.41	$144.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.90 / $168.89 / $228.81	Facility		$144.90	$168.89	$228.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $33.14 / $71.56	Professional		$8.18	$33.14	$71.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.40 / $46.64 / $62.97	Facility		$42.40	$46.64	$62.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $113.82 / $169.80	Professional		$107.72	$113.82	$169.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $84.13 / $224.09	Professional		$39.46	$84.13	$224.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.97 / $241.08 / $4,933.00	Facility		$67.97	$241.08	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $84.67 / $168.33	Professional		$53.95	$84.67	$168.33
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 $87.08 / $122.56 / $211.99	Professional		$87.08	$122.56	$211.99