Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.47 / $483.68 / $4,933.00	Facility		$131.47	$483.68	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.77 / $138.74 / $235.46	Professional		$98.77	$138.74	$235.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.88 / $198.90 / $198.90	Professional		$103.88	$198.90	$198.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $272.56 / $317.68 / $430.41	Facility		$272.56	$317.68	$430.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $77.56 / $159.57	Professional		$20.09	$77.56	$159.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.17 / $128.47 / $141.36	Facility		$95.17	$128.47	$141.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.08 / $170.34 / $184.42	Professional		$143.08	$170.34	$184.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.34 / $148.30 / $235.78	Professional		$103.34	$148.30	$235.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $157.77 / $476.66 / $2,056.00	Facility		$157.77	$476.66	$2,056.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.21 / $155.69 / $237.60	Professional		$120.21	$155.69	$237.60
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 / $1,247.00 / $1,844.00	Facility		$464.00	$1,247.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $152.15 / $181.16 / $240.78	Professional		$152.15	$181.16	$240.78