Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.96 / $176.27 / $355.98	Facility		$129.96	$176.27	$355.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.40 / $129.59 / $178.82	Professional		$95.40	$129.59	$178.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $129.31 / $142.88	Professional		$129.31	$129.31	$142.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.73 / $317.99 / $728.15	Facility		$217.73	$317.99	$728.15
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $159.00 / $228.68 / $282.22	Facility	50	$159.00	$228.68	$282.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.07 / $100.86 / $185.93	Professional		$21.07	$100.86	$185.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $116.18 / $139.41	Facility		$92.76	$116.18	$139.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.96 / $157.66 / $198.38	Professional		$117.96	$157.66	$198.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.22 / $139.25 / $226.94	Professional		$92.22	$139.25	$226.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.96 / $170.90 / $413.48	Facility		$129.96	$170.90	$413.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $137.93 / $202.03	Professional		$119.84	$137.93	$202.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $135.99 / $193.70	Professional		$109.37	$135.99	$193.70
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 $137.66 / $166.84 / $218.48	Professional		$137.66	$166.84	$218.48