Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.68 / $1,958.00 / $4,933.00	Facility		$294.68	$1,958.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.08 / $260.66 / $491.91	Professional		$183.08	$260.66	$491.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.91 / $179.91 / $194.45	Professional		$179.91	$179.91	$194.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,534.66 / $1,788.70 / $2,423.40	Facility		$1,534.66	$1,788.70	$2,423.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $267.29 / $353.11	Professional		$47.83	$267.29	$353.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.51 / $239.64 / $263.64	Facility		$177.51	$239.64	$263.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.96 / $207.96 / $247.58	Professional		$207.96	$207.96	$247.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.68 / $319.36 / $450.32	Professional		$159.68	$319.36	$450.32
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $299.62 / $1,958.00 / $4,933.00	Facility		$299.62	$1,958.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $214.32 / $299.62 / $530.15	Professional		$214.32	$299.62	$530.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.58 / $201.58 / $301.60	Professional		$125.58	$201.58	$301.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $3,640.00 / $6,740.00	Facility		$1,527.00	$3,640.00	$6,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $254.07 / $353.65 / $445.25	Professional		$254.07	$353.65	$445.25