Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.05 / $191.62 / $412.07	Facility		$78.05	$191.62	$412.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.65 / $191.62 / $204.45	Professional		$175.65	$191.62	$204.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.11 / $232.11 / $232.11	Professional		$232.11	$232.11	$232.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $507.84 / $1,011.82 / $1,842.86	Facility		$507.84	$1,011.82	$1,842.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $335.53 / $452.97	Professional		$318.75	$335.53	$452.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $201.16 / $201.16 / $218.09	Facility		$201.16	$201.16	$218.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $268.42 / $268.42 / $268.42	Professional		$268.42	$268.42	$268.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.42 / $216.42 / $244.45	Facility		$216.42	$216.42	$244.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.42 / $216.42 / $388.88	Professional		$216.42	$216.42	$388.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.05 / $242.47 / $412.07	Facility		$78.05	$242.47	$412.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $185.87 / $242.47 / $402.63	Professional		$185.87	$242.47	$402.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $203.59 / $248.29 / $285.53	Professional		$203.59	$248.29	$285.53
United Facility/Professional Facility Modifier Low / Median / High Price $2.54 / $153.02 / $195.90	Facility		$2.54	$153.02	$195.90
United Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $157.57 / $240.14	Professional		$120.89	$157.57	$240.14