Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,230.27 / $3,801.89	Facility		$354.81	$1,230.27	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $457.09 / $1,096.48	Professional		$245.47	$457.09	$1,096.48
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $104.71 / $158.49 / $338.84	Professional	53	$104.71	$158.49	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $436.52	Professional		$199.53	$245.47	$436.52
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	53	$257.04	$257.04	$257.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $371.54	Facility		$63.10	$63.10	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $724.44	Professional		$251.19	$398.11	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $316.23 / $426.58	Facility		$234.42	$316.23	$426.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $977.24	Professional		$416.87	$562.34	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $489.78 / $1,000.00	Professional		$269.15	$489.78	$1,000.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $1,318.26 / $3,548.13	Facility		$331.13	$1,318.26	$3,548.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $489.78 / $891.25	Professional		$263.03	$489.78	$891.25
Health Alliance Plan Facility/Professional Professional Modifier 53 Low / Median / High Price $85.11 / $162.18 / $218.78	Professional	53	$85.11	$162.18	$218.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $457.09 / $912.01	Professional		$257.04	$457.09	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,630.27 / $5,623.41	Facility		$588.84	$2,630.27	$5,623.41
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $457.09 / $741.31	Professional		$269.15	$457.09	$741.31