Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.43 / $177.45 / $4,933.00	Facility		$100.43	$177.45	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $124.87 / $178.18	Professional		$73.56	$124.87	$178.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $83.00 / $83.00	Professional		$83.00	$83.00	$83.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.94 / $236.54 / $320.47	Facility		$202.94	$236.54	$320.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.87 / $69.86 / $141.02	Professional		$16.87	$69.86	$141.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $90.65 / $122.39	Facility		$82.41	$90.65	$122.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.96 / $149.63 / $223.08	Professional		$140.96	$149.63	$223.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.76 / $123.62 / $374.07	Professional		$72.76	$123.62	$374.07
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $143.29 / $387.50 / $4,933.00	Facility		$143.29	$387.50	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $143.29 / $204.38	Professional		$85.32	$143.29	$204.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $119.07 / $168.26	Professional		$89.22	$119.07	$168.26
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 $131.59 / $160.06 / $205.07	Professional		$131.59	$160.06	$205.07