Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.56 / $2,108.96 / $5,605.03	Facility		$229.56	$2,108.96	$5,605.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.53 / $341.14 / $834.00	Professional		$174.53	$341.14	$834.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.85 / $224.84 / $330.80	Professional		$163.85	$224.84	$330.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,141.89 / $5,592.90 / $13,134.18	Facility		$4,141.89	$5,592.90	$13,134.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $192.13 / $432.79	Professional		$34.38	$192.13	$432.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.72 / $207.48 / $248.97	Facility		$162.72	$207.48	$248.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $215.02 / $267.99	Professional		$158.72	$215.02	$267.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.38 / $238.28 / $771.39	Professional		$132.38	$238.28	$771.39
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $221.06 / $2,108.96 / $5,756.00	Facility		$221.06	$2,108.96	$5,756.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $179.87 / $229.56 / $673.83	Professional		$179.87	$229.56	$673.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $207.69 / $296.69	Professional		$162.87	$207.69	$296.69
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 $182.97 / $247.77 / $868.90	Professional		$182.97	$247.77	$868.90