Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.28 / $1,886.92 / $4,933.00	Facility		$165.28	$1,886.92	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.13 / $129.94 / $165.29	Professional		$111.13	$129.94	$165.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.08 / $118.08 / $118.08	Professional		$118.08	$118.08	$118.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.16 / $561.22 / $760.37	Facility		$478.16	$561.22	$760.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $128.53 / $212.64	Professional		$31.43	$128.53	$212.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.53 / $148.10 / $177.72	Facility		$117.53	$148.10	$177.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.26 / $154.97 / $193.57	Professional		$114.26	$154.97	$193.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $150.29 / $263.72	Professional		$91.93	$150.29	$263.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.47 / $1,886.92 / $4,933.00	Facility		$131.47	$1,886.92	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $126.47 / $144.61 / $206.44	Professional		$126.47	$144.61	$206.44
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 $3,054.00 / $6,873.00 / $8,911.00	Facility		$3,054.00	$6,873.00	$8,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.46 / $155.51 / $210.33	Professional		$124.46	$155.51	$210.33