Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.24 / $1,311.32 / $4,933.00	Facility		$196.24	$1,311.32	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.50 / $175.67 / $235.97	Professional		$133.50	$175.67	$235.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.79 / $138.79 / $180.43	Professional		$138.79	$138.79	$180.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,109.78 / $1,516.97 / $3,498.24	Facility		$1,109.78	$1,516.97	$3,498.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $248.68 / $337.33	Professional		$40.44	$248.68	$337.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.54 / $172.18 / $189.44	Facility		$127.54	$172.18	$189.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.75 / $154.75 / $184.23	Professional		$154.75	$154.75	$184.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $209.82 / $305.45	Professional		$117.29	$209.82	$305.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $180.22 / $1,441.21 / $4,933.00	Facility		$180.22	$1,441.21	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $152.29 / $188.02 / $303.38	Professional		$152.29	$188.02	$303.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $136.77 / $196.66	Professional		$111.35	$136.77	$196.66
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,594.00	Facility		$773.00	$3,005.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $188.97 / $226.30 / $277.85	Professional		$188.97	$226.30	$277.85