Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.83 / $2,775.86 / $4,933.00	Facility		$396.83	$2,775.86	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.05 / $257.18 / $454.08	Professional		$155.05	$257.18	$454.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.61 / $122.61 / $122.61	Professional		$122.61	$122.61	$122.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.46 / $2,067.83 / $2,816.95	Facility		$1,771.46	$2,067.83	$2,816.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $204.63 / $303.87	Professional		$42.77	$204.63	$303.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.66 / $192.59 / $211.88	Facility		$142.66	$192.59	$211.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $285.33 / $339.69 / $360.67	Professional		$285.33	$339.69	$360.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $267.95 / $466.22	Professional		$153.65	$267.95	$466.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $245.54 / $2,740.00 / $4,933.00	Facility		$245.54	$2,740.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $286.69 / $523.80	Professional		$175.00	$286.69	$523.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.38 / $307.42 / $439.24	Professional		$245.38	$307.42	$439.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $283.58 / $353.32 / $494.28	Professional		$283.58	$353.32	$494.28