Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.98 / $171.98 / $171.98	Facility		$171.98	$171.98	$171.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.77 / $158.12 / $171.98	Professional		$94.77	$158.12	$171.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.65 / $161.69 / $290.08	Professional		$88.65	$161.69	$290.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $488.12 / $650.84 / $852.28	Facility		$488.12	$650.84	$852.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $133.10 / $239.58	Professional		$12.97	$133.10	$239.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.89 / $115.36 / $244.50	Facility		$12.89	$115.36	$244.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.20 / $106.49 / $300.93	Professional		$14.20	$106.49	$300.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.72 / $126.72 / $169.65	Facility		$126.72	$126.72	$169.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.72 / $155.83 / $220.68	Professional		$126.72	$155.83	$220.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $173.14 / $300.92	Professional		$27.18	$173.14	$300.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.09 / $136.82 / $220.68	Professional		$18.09	$136.82	$220.68
United Facility/Professional Professional Modifier Low / Median / High Price $92.66 / $185.37 / $348.37	Professional		$92.66	$185.37	$348.37