Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.33 / $884.52 / $6,384.61	Facility		$134.33	$884.52	$6,384.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $136.43 / $260.93	Professional		$75.30	$136.43	$260.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.82 / $118.31 / $236.63	Professional		$84.82	$118.31	$236.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $943.85 / $1,100.08 / $1,490.44	Facility		$943.85	$1,100.08	$1,490.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.43 / $116.75 / $172.30	Professional		$23.43	$116.75	$172.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.32 / $119.15 / $160.88	Facility		$108.32	$119.15	$160.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.75 / $173.53 / $258.47	Professional		$162.75	$173.53	$258.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.47 / $153.80 / $493.49	Professional		$100.47	$153.80	$493.49
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.04 / $865.57 / $6,358.24	Facility		$141.04	$865.57	$6,358.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $163.80 / $260.60	Professional		$78.68	$163.80	$260.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.03 / $151.64 / $216.82	Professional		$118.03	$151.64	$216.82
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,594.00	Facility		$773.00	$3,005.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $179.88 / $243.47	Professional		$130.41	$179.88	$243.47