Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $401.56 / $4,112.00 / $8,341.65	Facility		$401.56	$4,112.00	$8,341.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.14 / $1,214.21 / $1,437.50	Professional		$320.14	$1,214.21	$1,437.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $392.04 / $1,006.09 / $1,006.09	Professional		$392.04	$1,006.09	$1,006.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,570.44 / $4,880.47 / $11,254.77	Facility		$3,570.44	$4,880.47	$11,254.77
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,033.36 / $2,887.34 / $3,661.14	Facility	50	$2,033.36	$2,887.34	$3,661.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $426.67 / $822.87	Professional		$65.63	$426.67	$822.87
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $651.90 / $749.69 / $2,444.64	Professional	50	$651.90	$749.69	$2,444.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $260.25 / $351.34 / $386.54	Facility		$260.25	$351.34	$386.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $955.20 / $955.20 / $1,137.14	Professional		$955.20	$955.20	$1,137.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.86 / $745.01 / $2,577.19	Professional		$288.86	$745.01	$2,577.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,506.13 / $4,112.00 / $8,341.65	Facility		$1,506.13	$4,112.00	$8,341.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $368.79 / $1,375.00 / $2,142.83	Professional		$368.79	$1,375.00	$2,142.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $822.54 / $1,022.31 / $1,495.99	Professional		$822.54	$1,022.31	$1,495.99
United Facility/Professional Facility Modifier Low / Median / High Price $3,054.00 / $6,649.00 / $9,202.00	Facility		$3,054.00	$6,649.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,372.22 / $2,140.55 / $2,817.87	Professional		$1,372.22	$2,140.55	$2,817.87