Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.67 / $1,325.06 / $4,933.00	Facility		$127.67	$1,325.06	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $142.84 / $244.72	Professional		$79.86	$142.84	$244.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $157.05 / $157.05	Professional		$157.05	$157.05	$157.05
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 $22.09 / $116.19 / $162.47	Professional		$22.09	$116.19	$162.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.40 / $112.64 / $152.09	Facility		$102.40	$112.64	$152.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.19 / $161.08 / $239.98	Professional		$151.19	$161.08	$239.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.15 / $144.78 / $466.15	Professional		$95.15	$144.78	$466.15
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.96 / $1,663.74 / $4,933.00	Facility		$129.96	$1,663.74	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $101.18 / $155.43 / $243.52	Professional		$101.18	$155.43	$243.52
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 $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 $147.47 / $174.37 / $234.91	Professional		$147.47	$174.37	$234.91