Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,922.40 / $9,582.45 / $23,071.72	Facility		$1,922.40	$9,582.45	$23,071.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,301.97 / $1,851.20 / $5,510.00	Professional		$1,301.97	$1,851.20	$5,510.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $193.66 / $306.89 / $946.33	Professional	AS	$193.66	$306.89	$946.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,718.17 / $2,038.45 / $3,012.76	Professional		$1,718.17	$2,038.45	$3,012.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $23,871.75 / $28,018.42 / $37,960.50	Facility		$23,871.75	$28,018.42	$37,960.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.83 / $2,069.26 / $3,430.61	Professional		$425.83	$2,069.26	$3,430.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,369.75 / $1,780.68 / $2,534.42	Facility		$1,369.75	$1,780.68	$2,534.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,333.91 / $1,806.22 / $2,255.87	Professional		$1,333.91	$1,806.22	$2,255.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,056.49 / $1,724.77 / $3,067.28	Professional		$1,056.49	$1,724.77	$3,067.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,906.13 / $8,521.27 / $23,488.80	Facility		$1,906.13	$8,521.27	$23,488.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,424.00 / $1,851.20 / $3,279.13	Professional		$1,424.00	$1,851.20	$3,279.13
Health Alliance Plan Facility/Professional Professional Modifier AS Low / Median / High Price $193.66 / $306.89 / $329.02	Professional	AS	$193.66	$306.89	$329.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.33 / $976.24 / $1,627.54	Professional		$137.33	$976.24	$1,627.54
United Facility/Professional Facility Modifier Low / Median / High Price $5,356.00 / $11,464.00 / $15,011.00	Facility		$5,356.00	$11,464.00	$15,011.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,484.95 / $1,818.08 / $2,408.44	Professional		$1,484.95	$1,818.08	$2,408.44