Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.44 / $179.44 / $179.44	Facility		$179.44	$179.44	$179.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.77 / $165.90 / $179.44	Professional		$116.77	$165.90	$179.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $137.69 / $137.69	Professional		$137.69	$137.69	$137.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $631.33 / $841.76 / $1,102.29	Facility		$631.33	$841.76	$1,102.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.78 / $172.15 / $309.87	Professional		$16.78	$172.15	$309.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.19 / $19.04 / $213.36	Facility		$14.19	$19.04	$213.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.48 / $23.43 / $237.48	Professional		$17.48	$23.43	$237.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $123.98 / $126.46	Facility		$123.98	$123.98	$126.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.98 / $126.46 / $232.86	Professional		$123.98	$126.46	$232.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $179.43 / $218.60	Professional		$21.18	$179.43	$218.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.62 / $99.96 / $214.97	Professional		$17.62	$99.96	$214.97
United Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $122.23 / $204.46	Professional		$80.84	$122.23	$204.46