Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.64 / $304.64 / $304.64	Facility		$304.64	$304.64	$304.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.84 / $255.36 / $304.64	Professional		$153.84	$255.36	$304.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.14 / $214.52 / $415.02	Professional		$174.14	$214.52	$415.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.34 / $1,089.57 / $1,452.77	Facility		$85.34	$1,089.57	$1,452.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.11 / $226.88 / $408.39	Professional		$22.11	$226.88	$408.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.73 / $46.69 / $466.90	Facility		$18.73	$46.69	$466.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.05 / $23.05 / $345.72	Professional		$23.05	$23.05	$345.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.40 / $193.40 / $258.98	Facility		$193.40	$193.40	$258.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.40 / $231.10 / $329.33	Professional		$193.40	$231.10	$329.33
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.81 / $239.11 / $360.12	Professional		$28.81	$239.11	$360.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.58 / $352.85 / $470.47	Professional		$38.58	$352.85	$470.47
United Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $34.95 / $249.35	Professional		$14.70	$34.95	$249.35