Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.69 / $157.41 / $4,933.00	Facility		$73.69	$157.41	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $97.62 / $198.33	Professional		$57.00	$97.62	$198.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $121.48 / $133.49	Professional		$112.49	$121.48	$133.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.72 / $140.82 / $198.13	Facility		$120.72	$140.82	$198.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $47.99 / $92.29	Professional		$12.48	$47.99	$92.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.08 / $64.98 / $87.75	Facility		$59.08	$64.98	$87.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $136.62 / $203.58	Professional		$128.44	$136.62	$203.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.40 / $106.64 / $260.41	Professional		$54.40	$106.64	$260.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $92.84 / $157.41 / $4,933.00	Facility		$92.84	$157.41	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.68 / $106.29 / $198.33	Professional		$73.68	$106.29	$198.33
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 $107.54 / $127.95 / $180.13	Professional		$107.54	$127.95	$180.13