Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.73 / $768.33 / $4,933.00	Facility		$288.73	$768.33	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.18 / $409.38 / $626.54	Professional		$233.18	$409.38	$626.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.02 / $196.51 / $396.76	Professional		$192.02	$196.51	$396.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,081.54 / $1,474.56 / $3,535.72	Facility		$1,081.54	$1,474.56	$3,535.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $320.27 / $455.13	Professional		$57.32	$320.27	$455.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.70 / $267.13 / $324.80	Facility		$213.70	$267.13	$324.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $453.61 / $575.86 / $811.97	Professional		$453.61	$575.86	$811.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.09 / $494.86 / $917.91	Professional		$250.09	$494.86	$917.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $288.73 / $768.33 / $4,933.00	Facility		$288.73	$768.33	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $263.30 / $476.89 / $716.96	Professional		$263.30	$476.89	$716.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $401.50 / $508.20 / $734.63	Professional		$401.50	$508.20	$734.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $4,857.00 / $6,036.00	Facility		$1,050.00	$4,857.00	$6,036.00
United Facility/Professional Professional Modifier Low / Median / High Price $486.33 / $602.13 / $784.74	Professional		$486.33	$602.13	$784.74