Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.65 / $2,056.00 / $4,933.00	Facility		$90.65	$2,056.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $90.65 / $169.69	Professional		$67.95	$90.65	$169.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $78.23 / $78.23	Professional		$78.23	$78.23	$78.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $356.33 / $415.94 / $566.62	Facility		$356.33	$415.94	$566.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $106.45 / $128.86	Professional		$19.80	$106.45	$128.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.42 / $96.42 / $106.08	Facility		$71.42	$96.42	$106.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $84.21 / $94.26	Professional		$70.73	$84.21	$94.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $85.15 / $154.63	Professional		$65.90	$85.15	$154.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.64 / $2,056.00 / $4,933.00	Facility		$81.64	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $93.88 / $202.35	Professional		$76.98	$93.88	$202.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $68.34 / $97.88	Professional		$54.90	$68.34	$97.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,906.00 / $4,645.00 / $6,327.00	Facility		$1,906.00	$4,645.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $104.20 / $128.75	Professional		$85.59	$104.20	$128.75