Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.10 / $433.84 / $4,933.00	Facility		$55.10	$433.84	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.61 / $84.20 / $120.29	Professional		$41.61	$84.20	$120.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.70 / $78.70 / $78.70	Professional		$78.70	$78.70	$78.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.62 / $138.46 / $188.62	Facility		$118.62	$138.46	$188.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $75.59 / $114.66	Professional		$13.05	$75.59	$114.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.31 / $58.47 / $64.31	Facility		$43.31	$58.47	$64.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.58 / $106.64 / $112.32	Professional		$89.58	$106.64	$112.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $75.81 / $143.77	Professional		$48.00	$75.81	$143.77
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $75.20 / $433.84 / $4,933.00	Facility		$75.20	$433.84	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $101.60 / $142.63	Professional		$48.00	$101.60	$142.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $102.47 / $146.41	Professional		$81.79	$102.47	$146.41
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $120.30 / $160.08	Professional		$102.90	$120.30	$160.08