Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.09 / $2,056.00 / $4,933.00	Facility		$155.09	$2,056.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.84 / $123.09 / $155.10	Professional		$102.84	$123.09	$155.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.91 / $110.91 / $110.91	Professional		$110.91	$110.91	$110.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $408.75 / $479.75 / $649.99	Facility		$408.75	$479.75	$649.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.34 / $98.66 / $157.85	Professional		$23.34	$98.66	$157.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $110.36 / $139.09 / $166.91	Facility		$110.36	$139.09	$166.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.28 / $145.54 / $181.76	Professional		$107.28	$145.54	$181.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $142.10 / $247.87	Professional		$86.24	$142.10	$247.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $124.42 / $2,052.90 / $4,933.00	Facility		$124.42	$2,052.90	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $119.59 / $127.01 / $162.85	Professional		$119.59	$127.01	$162.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $117.26 / $146.22 / $200.05	Professional		$117.26	$146.22	$200.05