Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $245.48 / $464.00	Facility		$77.09	$245.48	$464.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $105.95 / $260.30	Professional		$64.45	$105.95	$260.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.51 / $47.27 / $64.67	Professional	52	$28.51	$47.27	$64.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.45 / $107.86 / $154.07	Professional		$68.45	$107.86	$154.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.38 / $157.80 / $213.79	Facility		$135.38	$157.80	$213.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.95 / $69.23 / $110.79	Professional		$13.95	$69.23	$110.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.84 / $70.22 / $94.82	Facility		$63.84	$70.22	$94.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.44 / $112.98 / $168.72	Professional		$107.44	$112.98	$168.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $97.67 / $299.26	Professional		$57.01	$97.67	$299.26
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $245.48 / $2,878.00	Facility		$77.09	$245.48	$2,878.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $108.70 / $200.86	Professional		$77.09	$108.70	$200.86
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $32.04 / $48.77 / $64.67	Professional	52	$32.04	$48.77	$64.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.21 / $119.07 / $168.26	Professional		$89.21	$119.07	$168.26
United Facility/Professional Facility Modifier Low / Median / High Price $155.74 / $1,247.00 / $2,029.00	Facility		$155.74	$1,247.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $120.35 / $156.32	Professional		$102.96	$120.35	$156.32