Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.85 / $302.85 / $302.85	Facility		$302.85	$302.85	$302.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.87 / $289.32 / $302.85	Professional		$200.87	$289.32	$302.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $319.61 / $319.61 / $438.14	Professional		$319.61	$319.61	$438.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,379.53 / $1,379.53 / $1,806.52	Facility		$1,379.53	$1,379.53	$1,806.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $282.13 / $507.83	Professional		$28.94	$282.13	$507.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.45 / $230.74 / $307.66	Facility		$24.45	$230.74	$307.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.10 / $225.70 / $378.66	Professional		$30.10	$225.70	$378.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.17 / $243.17 / $319.16	Facility		$243.17	$243.17	$319.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.17 / $306.51 / $347.14	Professional		$243.17	$306.51	$347.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $188.13 / $302.85 / $473.32	Professional		$188.13	$302.85	$473.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $215.22 / $347.14	Professional		$28.46	$215.22	$347.14
United Facility/Professional Professional Modifier Low / Median / High Price $151.41 / $241.08 / $393.04	Professional		$151.41	$241.08	$393.04