Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.81 / $921.81 / $1,209.95	Facility		$921.81	$921.81	$1,209.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $714.71 / $904.08 / $2,208.51	Professional		$714.71	$904.08	$2,208.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $748.87 / $748.87 / $881.02	Professional		$748.87	$748.87	$881.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.18 / $1,313.18 / $1,313.18	Facility		$1,313.18	$1,313.18	$1,313.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,233.43 / $1,378.84 / $1,641.48	Professional		$1,233.43	$1,378.84	$1,641.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $835.18 / $1,057.22 / $1,357.90	Facility		$835.18	$1,057.22	$1,357.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $822.97 / $1,085.73 / $1,375.47	Professional		$822.97	$1,085.73	$1,375.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,020.16 / $1,020.16 / $1,020.16	Facility		$1,020.16	$1,020.16	$1,020.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $768.96 / $1,057.32 / $2,755.28	Professional		$768.96	$1,057.32	$2,755.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $881.02 / $902.96 / $1,181.86	Facility		$881.02	$902.96	$1,181.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $794.42 / $921.81 / $2,002.00	Professional		$794.42	$921.81	$2,002.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $702.48 / $883.22 / $1,294.21	Professional		$702.48	$883.22	$1,294.21
United Facility/Professional Professional Modifier Low / Median / High Price $867.64 / $1,034.91 / $1,379.21	Professional		$867.64	$1,034.91	$1,379.21