Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.42 / $308.42 / $308.42	Facility		$308.42	$308.42	$308.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.50 / $274.97 / $308.42	Professional		$197.50	$274.97	$308.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $461.25 / $461.25 / $461.25	Professional		$461.25	$461.25	$461.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,356.42 / $1,356.42 / $1,776.26	Facility		$1,356.42	$1,356.42	$1,776.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $277.39 / $499.32	Professional		$28.45	$277.39	$499.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.88 / $186.60 / $327.06	Facility		$24.88	$186.60	$327.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.59 / $221.92 / $417.05	Professional		$29.59	$221.92	$417.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.42 / $243.42 / $325.88	Facility		$243.42	$243.42	$325.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.42 / $257.45 / $345.92	Professional		$243.42	$257.45	$345.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $295.89 / $469.17	Professional		$36.99	$295.89	$469.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $28.31 / $257.45	Professional		$21.10	$28.31	$257.45
United Facility/Professional Professional Modifier Low / Median / High Price $149.69 / $200.63 / $313.41	Professional		$149.69	$200.63	$313.41