Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.43 / $798.17 / $4,933.00	Facility		$92.43	$798.17	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $131.37 / $245.89	Professional		$87.28	$131.37	$245.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $87.84 / $87.84	Professional		$87.84	$87.84	$87.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.50 / $788.49 / $1,068.28	Facility		$676.50	$788.49	$1,068.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.46 / $75.47 / $146.56	Professional		$18.46	$75.47	$146.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.00 / $75.90 / $102.49	Facility		$69.00	$75.90	$102.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.79 / $113.67 / $168.47	Professional		$103.79	$113.67	$168.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $130.83 / $321.47	Professional		$77.88	$130.83	$321.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.37 / $957.53 / $4,933.00	Facility		$131.37	$957.53	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.03 / $135.19 / $223.67	Professional		$88.03	$135.19	$223.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $101.32 / $141.24	Professional		$81.79	$101.32	$141.24
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $168.23 / $222.84	Professional		$109.13	$168.23	$222.84