Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $220.00 / $349.29 / $3,620.12	Facility		$220.00	$349.29	$3,620.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.98 / $285.12 / $516.89	Professional		$166.98	$285.12	$516.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $211.76 / $416.36 / $416.36	Professional		$211.76	$416.36	$416.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $727.09 / $847.44 / $1,148.15	Facility		$727.09	$847.44	$1,148.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $148.19 / $282.25	Professional		$38.17	$148.19	$282.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.84 / $195.62 / $264.14	Facility		$177.84	$195.62	$264.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $287.02 / $305.33 / $454.98	Professional		$287.02	$305.33	$454.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.44 / $303.08 / $808.57	Professional		$187.44	$303.08	$808.57
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $220.00 / $349.29 / $3,620.12	Facility		$220.00	$349.29	$3,620.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $302.48 / $494.81	Professional		$204.96	$302.48	$494.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $247.12 / $363.41	Professional		$31.89	$247.12	$363.41
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 $279.01 / $333.11 / $428.76	Professional		$279.01	$333.11	$428.76