Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.27 / $842.72 / $4,933.00	Facility		$123.27	$842.72	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.75 / $130.19 / $266.00	Professional		$67.75	$130.19	$266.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $153.44 / $169.55	Professional		$153.44	$153.44	$169.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $542.58 / $632.40 / $856.80	Facility		$542.58	$632.40	$856.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $106.35 / $157.58	Professional		$21.35	$106.35	$157.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.91 / $108.80 / $146.90	Facility		$98.91	$108.80	$146.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.25 / $156.91 / $233.75	Professional		$147.25	$156.91	$233.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.84 / $139.09 / $451.76	Professional		$91.84	$139.09	$451.76
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $125.48 / $845.65 / $4,933.00	Facility		$125.48	$845.65	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.17 / $147.03 / $257.18	Professional		$88.17	$147.03	$257.18
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 $139.43 / $163.58 / $218.28	Professional		$139.43	$163.58	$218.28