Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.48 / $194.48 / $194.48	Facility		$194.48	$194.48	$194.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $158.02 / $194.48	Professional		$115.01	$158.02	$194.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.52 / $605.47 / $1,169.82	Facility		$304.52	$605.47	$1,169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $22.62 / $29.08	Professional		$20.46	$22.62	$29.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.54 / $28.00 / $35.10	Facility		$21.54	$28.00	$35.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $29.11 / $38.68	Professional		$21.56	$29.11	$38.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.10 / $147.10 / $147.10	Facility		$147.10	$147.10	$147.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $270.30	Professional		$107.38	$125.04	$270.30
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $10.52 / $105.17 / $194.48	Facility		$10.52	$105.17	$194.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $105.17 / $775.44	Professional		$10.52	$105.17	$775.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $28.33 / $39.66	Professional		$23.23	$28.33	$39.66
United Facility/Professional Professional Modifier Low / Median / High Price $9.82 / $17.98 / $81.62	Professional		$9.82	$17.98	$81.62