Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.69 / $464.00 / $3,549.62	Facility		$48.69	$464.00	$3,549.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $83.57 / $105.89	Professional		$38.64	$83.57	$105.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.61 / $35.51 / $47.22	Professional	52	$15.61	$35.51	$47.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.23 / $106.76 / $125.60	Professional		$63.23	$106.76	$125.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $312.50 / $364.23 / $493.48	Facility		$312.50	$364.23	$493.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.94 / $22.93 / $47.18	Professional		$5.94	$22.93	$47.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.23 / $38.11 / $41.93	Facility		$28.23	$38.11	$41.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.63 / $85.28 / $89.97	Professional		$71.63	$85.28	$89.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.18 / $69.73 / $127.39	Professional		$31.18	$69.73	$127.39
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $84.94 / $309.39 / $3,549.62	Facility		$84.94	$309.39	$3,549.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $83.50 / $124.66	Professional		$38.64	$83.50	$124.66
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $18.46 / $35.51 / $47.22	Professional	52	$18.46	$35.51	$47.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $102.47 / $146.41	Professional		$81.79	$102.47	$146.41
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.55 / $108.12 / $132.34	Professional		$83.55	$108.12	$132.34