Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.89 / $410.67 / $753.96	Facility		$101.89	$410.67	$753.96
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $49.06 / $63.78 / $106.38	Facility	52	$49.06	$63.78	$106.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.31 / $168.20 / $254.83	Professional		$79.31	$168.20	$254.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.43 / $77.43 / $77.43	Professional		$77.43	$77.43	$77.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $296.95 / $554.12 / $1,048.23	Facility		$296.95	$554.12	$1,048.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.67 / $119.74 / $153.94	Professional		$103.67	$119.74	$153.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.48 / $91.05 / $112.06	Facility		$72.48	$91.05	$112.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $150.88 / $190.74 / $328.87	Professional		$150.88	$190.74	$328.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.50 / $176.79 / $401.95	Professional		$81.50	$176.79	$401.95
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $127.56 / $410.67 / $753.96	Facility		$127.56	$410.67	$753.96
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $50.95 / $63.78 / $106.38	Facility	52	$50.95	$63.78	$106.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.69 / $182.75 / $262.22	Professional		$89.69	$182.75	$262.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.41 / $168.68 / $244.39	Professional		$135.41	$168.68	$244.39
United Facility/Professional Professional Modifier Low / Median / High Price $172.42 / $212.86 / $325.45	Professional		$172.42	$212.86	$325.45