Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.63 / $983.48 / $4,933.00	Facility		$306.63	$983.48	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.97 / $244.28 / $431.32	Professional		$172.97	$244.28	$431.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.68 / $284.74 / $474.95	Professional		$197.68	$284.74	$474.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $800.36 / $950.34 / $1,305.26	Facility		$800.36	$950.34	$1,305.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.27 / $144.56 / $266.00	Professional		$39.27	$144.56	$266.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.78 / $229.49 / $273.62	Facility		$181.78	$229.49	$273.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.83 / $343.36 / $484.67	Professional		$270.83	$343.36	$484.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.14 / $283.27 / $577.52	Professional		$169.14	$283.27	$577.52
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $306.63 / $983.48 / $4,933.00	Facility		$306.63	$983.48	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $200.46 / $271.70 / $453.11	Professional		$200.46	$271.70	$453.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $222.17 / $335.97	Professional		$30.56	$222.17	$335.97
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $254.65 / $339.53 / $445.79	Professional		$254.65	$339.53	$445.79