Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.14 / $461.50 / $4,933.00	Facility		$370.14	$461.50	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $277.61 / $288.27 / $313.60	Facility	54	$277.61	$288.27	$313.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.72 / $370.13 / $559.51	Professional		$259.72	$370.13	$559.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $377.76 / $456.05	Professional		$288.83	$377.76	$456.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $336.34 / $394.76 / $534.84	Facility		$336.34	$394.76	$534.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.27 / $318.48 / $591.65	Professional		$57.27	$318.48	$591.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $273.33 / $346.10 / $411.24	Facility		$273.33	$346.10	$411.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $294.49 / $395.24 / $496.76	Professional		$294.49	$395.24	$496.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.13 / $336.63 / $624.55	Professional		$237.13	$336.63	$624.55
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $315.35 / $461.50 / $4,933.00	Facility		$315.35	$461.50	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $277.61 / $277.61 / $301.98	Facility	54	$277.61	$277.61	$301.98
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $283.14 / $384.37 / $555.40	Professional		$283.14	$384.37	$555.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $195.22 / $360.97	Professional		$33.81	$195.22	$360.97
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 $310.10 / $368.27 / $534.96	Professional		$310.10	$368.27	$534.96