Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.29 / $167.01 / $4,933.00	Facility		$123.29	$167.01	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.29 / $167.01 / $384.60	Professional		$123.29	$167.01	$384.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.58 / $113.58 / $170.37	Professional		$113.58	$113.58	$170.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.13 / $640.03 / $867.14	Facility		$549.13	$640.03	$867.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $38.59 / $192.41	Professional		$26.25	$38.59	$192.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.19 / $108.01 / $145.84	Facility		$98.19	$108.01	$145.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $133.10 / $146.97 / $217.53	Professional		$133.10	$146.97	$217.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.08 / $192.65 / $462.77	Professional		$110.08	$192.65	$462.77
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $163.97 / $216.59 / $4,933.00	Facility		$163.97	$216.59	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $123.29 / $184.57 / $351.31	Professional		$123.29	$184.57	$351.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.81 / $135.75 / $190.24	Professional		$109.81	$135.75	$190.24
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 $134.79 / $241.36 / $334.40	Professional		$134.79	$241.36	$334.40