Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.70 / $304.70 / $304.70	Facility		$304.70	$304.70	$304.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.25 / $272.83 / $304.70	Professional		$196.25	$272.83	$304.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $340.14 / $340.14 / $340.14	Professional		$340.14	$340.14	$340.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,347.77 / $1,347.77 / $1,764.93	Facility		$1,347.77	$1,347.77	$1,764.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $349.13 / $496.14	Professional		$26.86	$349.13	$496.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.59 / $238.88 / $330.75	Facility		$24.59	$238.88	$330.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $220.51 / $407.07	Professional		$29.40	$220.51	$407.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $243.78 / $326.36	Facility		$243.78	$243.78	$326.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $272.11 / $327.93	Professional		$243.78	$272.11	$327.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $304.70 / $478.03	Professional		$36.77	$304.70	$478.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $29.94 / $272.11	Professional		$22.32	$29.94	$272.11
United Facility/Professional Professional Modifier Low / Median / High Price $155.96 / $243.26 / $354.94	Professional		$155.96	$243.26	$354.94