Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.70 / $464.00 / $4,933.00	Facility		$73.70	$464.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $85.31 / $153.99	Professional		$53.71	$85.31	$153.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $76.34 / $96.16	Professional		$76.34	$76.34	$96.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.11 / $1,192.47 / $1,615.61	Facility		$1,023.11	$1,192.47	$1,615.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $63.23 / $93.84	Professional		$10.74	$63.23	$93.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $75.59 / $83.17	Facility		$56.00	$75.59	$83.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.27 / $107.46 / $115.93	Professional		$90.27	$107.46	$115.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $89.81 / $148.79	Professional		$60.59	$89.81	$148.79
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $85.04 / $807.30 / $4,933.00	Facility		$85.04	$807.30	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $93.40 / $149.60	Professional		$70.76	$93.40	$149.60
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 $773.00 / $3,005.00 / $4,504.00	Facility		$773.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $112.35 / $150.13	Professional		$92.59	$112.35	$150.13