Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.62 / $245.48 / $4,933.00	Facility		$128.62	$245.48	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $154.34 / $252.45	Professional		$98.87	$154.34	$252.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.21 / $175.32 / $245.55	Professional		$111.21	$175.32	$245.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.59 / $234.96 / $318.33	Facility		$201.59	$234.96	$318.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $85.26 / $177.07	Professional		$21.19	$85.26	$177.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.75 / $114.13 / $154.10	Facility		$103.75	$114.13	$154.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.48 / $180.07 / $268.42	Professional		$169.48	$180.07	$268.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.23 / $154.27 / $470.47	Professional		$96.23	$154.27	$470.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $174.33 / $366.44 / $4,933.00	Facility		$174.33	$366.44	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.62 / $174.33 / $267.37	Professional		$128.62	$174.33	$267.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.03 / $172.02 / $244.86	Professional		$118.03	$172.02	$244.86
United Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $1,209.00 / $2,029.00	Facility		$700.00	$1,209.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $153.69 / $192.29 / $249.51	Professional		$153.69	$192.29	$249.51