Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.90 / $1,645.54 / $4,933.00	Facility		$102.90	$1,645.54	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $123.03 / $213.49	Professional		$79.93	$123.03	$213.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.03 / $117.03 / $117.03	Professional		$117.03	$117.03	$117.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $528.71 / $767.39 / $1,844.81	Facility		$528.71	$767.39	$1,844.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $110.70 / $134.01	Professional		$19.80	$110.70	$134.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.05 / $93.25 / $111.90	Facility		$74.05	$93.25	$111.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $158.88 / $246.15	Professional		$119.45	$158.88	$246.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $124.15 / $246.03	Professional		$68.88	$124.15	$246.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $151.94 / $1,645.54 / $4,933.00	Facility		$151.94	$1,645.54	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $151.94 / $229.05	Professional		$102.90	$151.94	$229.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $135.99 / $193.70	Professional		$109.37	$135.99	$193.70
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 $149.41 / $189.79 / $249.87	Professional		$149.41	$189.79	$249.87