Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.91 / $511.74 / $2,877.00	Facility		$157.91	$511.74	$2,877.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.10 / $195.59 / $258.35	Professional		$126.10	$195.59	$258.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.78 / $103.78 / $103.78	Professional		$103.78	$103.78	$103.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $394.12 / $535.91 / $1,258.54	Facility		$394.12	$535.91	$1,258.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $112.36 / $199.96	Professional		$31.79	$112.36	$199.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.78 / $152.25 / $167.51	Facility		$112.78	$152.25	$167.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $185.71 / $221.09 / $235.43	Professional		$185.71	$221.09	$235.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.26 / $185.84 / $307.57	Professional		$121.26	$185.84	$307.57
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $248.20 / $501.03 / $2,877.00	Facility		$248.20	$501.03	$2,877.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $152.06 / $217.33 / $368.00	Professional		$152.06	$217.33	$368.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $204.94 / $292.83	Professional		$163.59	$204.94	$292.83
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $206.90 / $247.58 / $357.80	Professional		$206.90	$247.58	$357.80