Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.02 / $1,888.13 / $4,933.00	Facility		$255.02	$1,888.13	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.02 / $255.02 / $3,348.31	Professional		$195.02	$255.02	$3,348.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.57 / $184.57 / $184.57	Professional		$184.57	$184.57	$184.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,048.55 / $1,222.11 / $1,655.77	Facility		$1,048.55	$1,222.11	$1,655.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $291.08 / $432.27	Professional		$60.55	$291.08	$432.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.82 / $223.10 / $301.24	Facility		$202.82	$223.10	$301.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $201.44 / $226.39 / $334.02	Professional		$201.44	$226.39	$334.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.25 / $249.21 / $819.47	Professional		$176.25	$249.21	$819.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $233.49 / $1,888.13 / $4,933.00	Facility		$233.49	$1,888.13	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $209.50 / $255.02 / $1,261.92	Professional		$209.50	$255.02	$1,261.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $191.62 / $240.09 / $335.36	Professional		$191.62	$240.09	$335.36
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 $204.96 / $266.07 / $358.38	Professional		$204.96	$266.07	$358.38