Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $334.40 / $1,495.54 / $4,933.00	Facility		$334.40	$1,495.54	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.14 / $347.26 / $980.10	Professional		$231.14	$347.26	$980.10
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $35.06 / $55.56 / $111.36	Professional	AS	$35.06	$55.56	$111.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $280.92 / $280.92 / $355.97	Professional		$280.92	$280.92	$355.97
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $38.21 / $51.34 / $51.34	Professional	AS	$38.21	$51.34	$51.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,242.98 / $1,458.89 / $1,976.57	Facility		$1,242.98	$1,458.89	$1,976.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.14 / $240.89 / $416.28	Professional		$68.14	$240.89	$416.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.60 / $319.00 / $382.80	Facility		$245.60	$319.00	$382.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $238.04 / $327.17 / $404.49	Professional		$238.04	$327.17	$404.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.56 / $312.33 / $522.51	Professional		$198.56	$312.33	$522.51
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $280.83 / $1,495.54 / $4,933.00	Facility		$280.83	$1,495.54	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $248.23 / $334.40 / $690.30	Professional		$248.23	$334.40	$690.30
Health Alliance Plan Facility/Professional Professional Modifier AS Low / Median / High Price $16.57 / $55.30 / $111.36	Professional	AS	$16.57	$55.30	$111.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $191.62 / $242.02 / $345.78	Professional		$191.62	$242.02	$345.78
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,449.00	Facility		$464.00	$1,428.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $273.91 / $344.79 / $467.00	Professional		$273.91	$344.79	$467.00