Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $310.43 / $310.43	Facility		$310.43	$310.43	$310.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.71 / $291.95 / $310.43	Professional		$250.71	$291.95	$310.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $543.58 / $543.58 / $543.58	Professional		$543.58	$543.58	$543.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $822.74 / $1,639.22 / $2,985.56	Facility		$822.74	$1,639.22	$2,985.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $516.40 / $543.58 / $733.83	Professional		$516.40	$543.58	$733.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $273.57 / $278.94 / $353.33	Facility		$273.57	$278.94	$353.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $434.86 / $434.86 / $434.86	Professional		$434.86	$434.86	$434.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.73 / $315.73 / $350.29	Facility		$315.73	$315.73	$350.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.73 / $315.73 / $630.00	Professional		$315.73	$315.73	$630.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $392.84 / $392.84	Facility		$310.43	$392.84	$392.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $250.71 / $392.84 / $554.45	Professional		$250.71	$392.84	$554.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $329.84 / $402.25 / $462.58	Professional		$329.84	$402.25	$462.58
United Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $243.26 / $243.26	Facility		$243.26	$243.26	$243.26
United Facility/Professional Professional Modifier Low / Median / High Price $173.54 / $245.12 / $361.58	Professional		$173.54	$245.12	$361.58