Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.78 / $438.03 / $2,878.00	Facility		$197.78	$438.03	$2,878.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $165.81 / $343.59	Professional		$111.95	$165.81	$343.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.26 / $134.26 / $211.43	Professional		$134.26	$134.26	$211.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.68 / $460.89 / $624.42	Facility		$392.68	$460.89	$624.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $184.75 / $221.70	Professional		$31.41	$184.75	$221.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.14 / $151.63 / $181.95	Facility		$117.14	$151.63	$181.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.59 / $190.09 / $301.01	Professional		$138.59	$190.09	$301.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $169.59 / $286.45	Professional		$109.93	$169.59	$286.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $159.66 / $460.89 / $2,056.00	Facility		$159.66	$460.89	$2,056.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $125.97 / $182.18 / $300.05	Professional		$125.97	$182.18	$300.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $156.41 / $232.25	Professional		$115.20	$156.41	$232.25
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.09 / $186.37 / $237.90	Professional		$150.09	$186.37	$237.90