Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,016.63 / $1,958.00 / $7,592.56	Facility		$1,016.63	$1,958.00	$7,592.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $786.29 / $1,016.63 / $1,641.88	Professional		$786.29	$1,016.63	$1,641.88
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $91.50 / $98.52 / $98.52	Professional	AS	$91.50	$98.52	$98.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $916.07 / $916.07 / $916.07	Professional		$916.07	$916.07	$916.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,733.56 / $3,186.06 / $4,316.60	Facility		$2,733.56	$3,186.06	$4,316.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.37 / $874.19 / $1,738.94	Professional		$248.37	$874.19	$1,738.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $818.07 / $899.88 / $1,215.05	Facility		$818.07	$899.88	$1,215.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,025.35 / $1,117.58 / $1,657.90	Professional		$1,025.35	$1,117.58	$1,657.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.93 / $1,079.57 / $3,611.23	Professional		$748.93	$1,079.57	$3,611.23
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,067.46 / $2,842.14 / $8,596.94	Facility		$1,067.46	$2,842.14	$8,596.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $860.22 / $1,108.68 / $1,645.25	Professional		$860.22	$1,108.68	$1,645.25
Health Alliance Plan Facility/Professional Professional Modifier AS Low / Median / High Price $91.50 / $98.52 / $98.52	Professional	AS	$91.50	$98.52	$98.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.24 / $756.64 / $1,232.37	Professional		$102.24	$756.64	$1,232.37
United Facility/Professional Facility Modifier Low / Median / High Price $3,296.00 / $7,500.00 / $10,556.00	Facility		$3,296.00	$7,500.00	$10,556.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,002.36 / $1,243.68 / $1,610.86	Professional		$1,002.36	$1,243.68	$1,610.86