Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.55 / $1,945.67 / $8,278.14	Facility		$175.55	$1,945.67	$8,278.14
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.53 / $87.78 / $164.67	Facility	52	$84.53	$87.78	$164.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.95 / $175.55 / $366.79	Professional		$1.95	$175.55	$366.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $179.27 / $179.27	Professional		$60.42	$179.27	$179.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,244.25 / $2,619.71 / $3,568.77	Facility		$2,244.25	$2,619.71	$3,568.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $209.84 / $338.45	Professional		$39.24	$209.84	$338.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.62 / $168.24 / $185.09	Facility		$124.62	$168.24	$185.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $242.96 / $289.24 / $305.54	Professional		$242.96	$289.24	$305.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $228.56 / $405.08	Professional		$137.47	$228.56	$405.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $312.52 / $2,740.00 / $9,568.18	Facility		$312.52	$2,740.00	$9,568.18
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $84.53 / $84.53 / $158.57	Facility	52	$84.53	$84.53	$158.57
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2.54 / $272.56 / $418.62	Professional		$2.54	$272.56	$418.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.54 / $272.95 / $390.71	Professional		$219.54	$272.95	$390.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,257.06 / $3,569.00 / $6,036.00	Facility		$1,257.06	$3,569.00	$6,036.00
United Facility/Professional Professional Modifier Low / Median / High Price $276.64 / $347.98 / $496.19	Professional		$276.64	$347.98	$496.19