Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.69 / $1,924.00 / $3,525.06	Facility		$211.69	$1,924.00	$3,525.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $124.12 / $211.70	Professional		$68.87	$124.12	$211.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.02 / $95.02 / $95.02	Professional		$95.02	$95.02	$95.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,130.30 / $1,319.40 / $1,797.38	Facility		$1,130.30	$1,319.40	$1,797.38
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $609.91 / $1,013.80 / $1,218.67	Facility	50	$609.91	$1,013.80	$1,218.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $133.33 / $257.14	Professional		$22.45	$133.33	$257.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $108.47 / $119.34	Facility		$80.34	$108.47	$119.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.11 / $194.18 / $205.00	Professional		$163.11	$194.18	$205.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.37 / $149.15 / $299.69	Professional		$80.37	$149.15	$299.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $211.69 / $1,924.00 / $3,544.00	Facility		$211.69	$1,924.00	$3,544.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $105.20 / $157.97 / $239.14	Professional		$105.20	$157.97	$239.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $170.59 / $244.30	Professional		$137.22	$170.59	$244.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.53 / $153.74 / $225.46	Professional		$134.53	$153.74	$225.46