Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.93 / $464.00 / $4,933.00	Facility		$216.93	$464.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $216.93 / $373.78	Professional		$124.07	$216.93	$373.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $211.95 / $274.08 / $302.87	Professional		$211.95	$274.08	$302.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $863.91 / $1,008.44 / $1,373.77	Facility		$863.91	$1,008.44	$1,373.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $253.10 / $303.72	Professional		$49.46	$253.10	$303.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.61 / $230.32 / $253.40	Facility		$170.61	$230.32	$253.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $243.15 / $289.45 / $324.16	Professional		$243.15	$289.45	$324.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.03 / $202.88 / $359.00	Professional		$145.03	$202.88	$359.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $274.88 / $2,056.00 / $4,933.00	Facility		$274.88	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $203.27 / $274.88 / $391.41	Professional		$203.27	$274.88	$391.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.51 / $275.89 / $398.73	Professional		$216.51	$275.89	$398.73
United Facility/Professional Facility Modifier Low / Median / High Price $850.00 / $4,645.00 / $6,327.00	Facility		$850.00	$4,645.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $158.61 / $225.84 / $372.36	Professional		$158.61	$225.84	$372.36