Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.06 / $881.07 / $1,773.56	Facility		$187.06	$881.07	$1,773.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.22 / $187.92 / $266.60	Professional		$115.22	$187.92	$266.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.27 / $107.27 / $107.27	Professional		$107.27	$107.27	$107.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $816.27 / $1,115.77 / $2,573.06	Facility		$816.27	$1,115.77	$2,573.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $127.63 / $187.82	Professional		$30.97	$127.63	$187.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $136.32 / $149.97	Facility		$100.98	$136.32	$149.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.35 / $146.35 / $174.23	Professional		$146.35	$146.35	$174.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $200.82 / $321.73	Professional		$107.92	$200.82	$321.73
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $182.61 / $940.95 / $1,863.96	Facility		$182.61	$940.95	$1,863.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $122.57 / $201.97 / $296.33	Professional		$122.57	$201.97	$296.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $136.77 / $196.66	Professional		$111.35	$136.77	$196.66
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,594.00	Facility		$773.00	$3,005.00	$4,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $178.76 / $234.53 / $384.79	Professional		$178.76	$234.53	$384.79