Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.52 / $775.04 / $4,933.00	Facility		$252.52	$775.04	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $126.26 / $126.26 / $387.52	Facility	52	$126.26	$126.26	$387.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.70 / $293.56 / $809.78	Professional		$212.70	$293.56	$809.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.19 / $188.55 / $377.10	Professional		$159.19	$188.55	$377.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,822.71 / $2,694.89 / $3,720.56	Facility		$1,822.71	$2,694.89	$3,720.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $193.79 / $328.46	Professional		$50.20	$193.79	$328.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $205.32 / $260.58 / $400.18	Facility		$205.32	$260.58	$400.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,225.02 / $1,225.02 / $1,575.62	Professional		$1,225.02	$1,225.02	$1,575.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $445.61 / $1,176.42	Professional		$212.50	$445.61	$1,176.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $252.52 / $1,001.54 / $4,933.00	Facility		$252.52	$1,001.54	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $126.26 / $126.26 / $387.52	Facility	52	$126.26	$126.26	$387.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $247.28 / $372.29 / $827.07	Professional		$247.28	$372.29	$827.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $485.27 / $606.59 / $869.16	Professional		$485.27	$606.59	$869.16
United Facility/Professional Facility Modifier Low / Median / High Price $732.17 / $3,569.00 / $6,029.00	Facility		$732.17	$3,569.00	$6,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $351.23 / $674.51 / $1,084.01	Professional		$351.23	$674.51	$1,084.01