Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.44 / $125.02 / $4,933.00	Facility		$53.44	$125.02	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $63.20 / $101.88	Professional		$44.00	$63.20	$101.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $62.86 / $69.06	Professional		$58.66	$62.86	$69.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $262.63 / $306.11 / $414.72	Facility		$262.63	$306.11	$414.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.01 / $48.25 / $71.56	Professional		$9.01	$48.25	$71.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.36 / $46.60 / $62.91	Facility		$42.36	$46.60	$62.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $71.26 / $106.16	Professional		$66.84	$71.26	$106.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.67 / $63.17 / $188.47	Professional		$39.67	$63.17	$188.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.18 / $139.61 / $4,933.00	Facility		$70.18	$139.61	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.43 / $70.18 / $105.67	Professional		$53.43	$70.18	$105.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $67.87 / $95.12	Professional		$54.90	$67.87	$95.12
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,209.00 / $2,029.00	Facility		$464.00	$1,209.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $77.25 / $102.03	Professional		$62.05	$77.25	$102.03