Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.21 / $622.61 / $2,056.00	Facility		$84.21	$622.61	$2,056.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.54 / $83.09 / $384.24	Facility	52	$40.54	$83.09	$384.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.79 / $137.88 / $237.89	Professional		$67.79	$137.88	$237.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $68.86 / $68.86	Professional		$68.86	$68.86	$68.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,233.59 / $1,665.76 / $3,911.81	Facility		$1,233.59	$1,665.76	$3,911.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $60.06 / $110.53	Professional		$16.32	$60.06	$110.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.49 / $79.41 / $95.30	Facility		$61.49	$79.41	$95.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $175.44 / $271.58	Professional		$129.75	$175.44	$271.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.86 / $113.14 / $220.56	Professional		$57.86	$113.14	$220.56
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $84.21 / $924.80 / $2,056.00	Facility		$84.21	$924.80	$2,056.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $40.54 / $83.09 / $384.24	Facility	52	$40.54	$83.09	$384.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $156.66 / $246.34	Professional		$81.09	$156.66	$246.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.71 / $135.73 / $192.57	Professional		$108.71	$135.73	$192.57
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $147.88 / $179.10 / $252.93	Professional		$147.88	$179.10	$252.93