Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.01 / $298.52 / $620.91	Facility		$199.01	$298.52	$620.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.57 / $197.94 / $401.36	Professional		$138.57	$197.94	$401.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.36 / $193.67 / $242.04	Professional		$161.36	$193.67	$242.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $253.97 / $253.97 / $253.97	Facility		$253.97	$253.97	$253.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.27 / $266.67 / $304.76	Professional		$241.27	$266.67	$304.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $160.27 / $176.30 / $224.38	Facility		$160.27	$176.30	$224.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.35 / $239.81 / $370.67	Professional		$208.35	$239.81	$370.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.00 / $256.11 / $371.98	Professional		$147.00	$256.11	$371.98
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $128.30 / $298.52 / $1,360.56	Facility		$128.30	$298.52	$1,360.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.30 / $194.14 / $362.98	Professional		$128.30	$194.14	$362.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.75 / $165.30 / $202.16	Professional		$136.75	$165.30	$202.16
United Facility/Professional Professional Modifier Low / Median / High Price $143.83 / $194.29 / $244.75	Professional		$143.83	$194.29	$244.75