Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.90 / $1,350.39 / $4,933.00	Facility		$91.90	$1,350.39	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.83 / $128.72 / $238.98	Professional		$73.83	$128.72	$238.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $149.55 / $149.55	Professional		$77.79	$149.55	$149.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,015.99 / $1,185.96 / $1,615.61	Facility		$1,015.99	$1,185.96	$1,615.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.16 / $61.97 / $115.88	Professional		$15.16	$61.97	$115.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.14 / $96.04 / $105.67	Facility		$71.14	$96.04	$105.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.75 / $168.75 / $179.84	Professional		$141.75	$168.75	$179.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $124.43 / $239.99	Professional		$64.86	$124.43	$239.99
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $115.80 / $1,529.71 / $4,933.00	Facility		$115.80	$1,529.71	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $143.22 / $233.47	Professional		$88.23	$143.22	$233.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $136.45 / $195.19	Professional		$108.90	$136.45	$195.19
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 $143.85 / $170.47 / $235.80	Professional		$143.85	$170.47	$235.80