Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.21 / $464.00 / $4,933.00	Facility		$170.21	$464.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.00 / $170.21 / $267.81	Professional		$122.00	$170.21	$267.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.63 / $95.86 / $174.47	Professional		$80.63	$95.86	$174.47
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 $31.04 / $115.20 / $195.25	Professional		$31.04	$115.20	$195.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.26 / $190.26 / $190.26	Facility		$190.26	$190.26	$190.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.60 / $182.36 / $628.73	Professional		$127.60	$182.36	$628.73
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $173.27 / $321.26 / $4,933.00	Facility		$173.27	$321.26	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $154.75 / $189.18 / $281.20	Professional		$154.75	$189.18	$281.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.56 / $170.59 / $241.73	Professional		$123.56	$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 $166.57 / $209.53 / $280.14	Professional		$166.57	$209.53	$280.14