Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.28 / $102.01 / $5,785.20	Facility		$77.28	$102.01	$5,785.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $76.53 / $92.18	Professional		$75.03	$76.53	$92.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Professional		$75.03	$75.03	$75.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.16 / $163.63 / $311.80	Facility		$87.16	$163.63	$311.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.27 / $78.02 / $101.28	Professional		$71.27	$78.02	$101.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $82.53 / $114.27	Facility		$75.03	$82.53	$114.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $78.78 / $173.97	Professional		$75.03	$78.78	$173.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $75.02 / $97.96	Professional		$75.02	$75.02	$97.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $124.67 / $218.34	Facility		$75.03	$124.67	$218.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $77.28 / $97.53	Professional		$75.03	$77.28	$97.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $82.53 / $112.54	Professional		$75.03	$82.53	$112.54
United Facility/Professional Facility Modifier Low / Median / High Price $75.69 / $75.69 / $80.23	Facility		$75.69	$75.69	$80.23
United Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $83.52 / $96.05	Professional		$75.03	$83.52	$96.05