Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $358.08 / $358.08 / $358.08	Facility		$358.08	$358.08	$358.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.30 / $296.10 / $358.08	Professional		$232.30	$296.10	$358.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $15.60 / $90.00	Professional		$15.60	$15.60	$90.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $637.04 / $1,266.58 / $2,447.16	Facility		$637.04	$1,266.58	$2,447.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $47.31 / $60.83	Professional		$42.81	$47.31	$60.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.71 / $51.82 / $67.59	Facility		$31.71	$51.82	$67.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.68 / $58.58 / $74.69	Professional		$38.68	$58.58	$74.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.33 / $61.57 / $592.28	Professional		$39.33	$61.57	$592.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $219.96 / $358.08	Facility		$22.00	$219.96	$358.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $240.63 / $1,972.08	Professional		$22.00	$240.63	$1,972.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $19.30 / $30.98 / $55.65	Professional		$19.30	$30.98	$55.65