Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.24 / $428.24 / $428.24	Facility		$428.24	$428.24	$428.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.20 / $428.24 / $429.90	Professional		$299.20	$428.24	$429.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $382.79 / $382.79 / $382.79	Professional		$382.79	$382.79	$382.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,157.91 / $2,157.91 / $2,825.83	Facility		$2,157.91	$2,157.91	$2,825.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $61.10 / $794.37	Professional		$43.00	$61.10	$794.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.43 / $38.00 / $430.94	Facility		$36.43	$38.00	$430.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $46.77 / $652.79	Professional		$44.83	$46.77	$652.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $279.36 / $279.36 / $382.62	Facility		$279.36	$279.36	$382.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.36 / $312.79 / $457.80	Professional		$279.36	$312.79	$457.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.05 / $422.69 / $560.40	Professional		$70.05	$422.69	$560.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $192.36 / $312.79 / $312.79	Professional		$192.36	$312.79	$312.79
United Facility/Professional Professional Modifier Low / Median / High Price $217.60 / $306.00 / $408.00	Professional		$217.60	$306.00	$408.00