Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.18 / $517.44 / $4,933.00	Facility		$164.18	$517.44	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.86 / $166.31 / $302.99	Professional		$131.86	$166.31	$302.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.72 / $172.22 / $290.89	Professional		$138.72	$172.22	$290.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $305.06 / $355.55 / $481.72	Facility		$305.06	$355.55	$481.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.83 / $103.60 / $181.55	Professional		$26.83	$103.60	$181.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.71 / $171.06 / $188.19	Facility		$126.71	$171.06	$188.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.15 / $189.46 / $207.23	Professional		$159.15	$189.46	$207.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.07 / $175.98 / $280.77	Professional		$121.07	$175.98	$280.77
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $179.12 / $552.29 / $4,933.00	Facility		$179.12	$552.29	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $194.53 / $302.99	Professional		$151.16	$194.53	$302.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.81 / $136.69 / $195.77	Professional		$109.81	$136.69	$195.77
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 $173.66 / $208.82 / $348.12	Professional		$173.66	$208.82	$348.12