Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $433.62 / $1,358.18	Facility		$181.74	$433.62	$1,358.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.44 / $181.74 / $780.00	Professional		$176.44	$181.74	$780.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $176.45 / $288.55	Professional		$155.41	$176.45	$288.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $212.57 / $399.09 / $760.45	Facility		$212.57	$399.09	$760.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.11 / $193.89 / $247.03	Professional		$177.11	$193.89	$247.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $176.45 / $256.44	Facility		$155.41	$176.45	$256.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $178.73 / $409.11	Professional		$176.45	$178.73	$409.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $222.93	Professional		$176.45	$176.45	$222.93
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $445.42 / $1,740.00	Facility		$181.74	$445.42	$1,740.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $160.08 / $180.54 / $312.16	Professional		$160.08	$180.54	$312.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $176.45 / $247.03	Professional		$155.41	$176.45	$247.03
United Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $196.43 / $225.89	Professional		$176.45	$196.43	$225.89