Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.59 / $1,958.00 / $6,330.23	Facility		$157.59	$1,958.00	$6,330.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.39 / $158.75 / $274.18	Professional		$86.39	$158.75	$274.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.09 / $165.45 / $177.80	Professional		$124.09	$165.45	$177.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,193.33 / $2,995.95 / $6,903.63	Facility		$2,193.33	$2,995.95	$6,903.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.36 / $108.99 / $220.01	Professional		$27.36	$108.99	$220.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.96 / $140.76 / $190.05	Facility		$127.96	$140.76	$190.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $170.12 / $182.00 / $270.92	Professional		$170.12	$182.00	$270.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.10 / $168.18 / $584.13	Professional		$118.10	$168.18	$584.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $160.41 / $1,924.00 / $4,933.00	Facility		$160.41	$1,924.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $121.60 / $173.46 / $272.02	Professional		$121.60	$173.46	$272.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $170.59 / $241.73	Professional		$123.42	$170.59	$241.73
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 $147.54 / $192.92 / $248.69	Professional		$147.54	$192.92	$248.69