Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.04 / $450.04 / $638.29	Facility		$450.04	$450.04	$638.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.95 / $450.04 / $670.27	Professional		$340.95	$450.04	$670.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $700.00 / $975.24	Professional		$700.00	$700.00	$975.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $966.41 / $1,925.46 / $3,506.90	Facility		$966.41	$1,925.46	$3,506.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $606.57 / $638.50 / $861.98	Professional		$606.57	$638.50	$861.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $415.03 / $415.03 / $488.90	Facility		$415.03	$415.03	$488.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $510.80 / $510.80 / $510.80	Professional		$510.80	$510.80	$510.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.58 / $736.58 / $761.97	Facility		$736.58	$736.58	$761.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.70 / $855.00 / $1,068.75	Professional		$537.70	$855.00	$1,068.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $450.04 / $638.29 / $771.23	Facility		$450.04	$638.29	$771.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $450.04 / $670.27 / $848.35	Professional		$450.04	$670.27	$848.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $613.42 / $721.68 / $829.93	Professional		$613.42	$721.68	$829.93
United Facility/Professional Professional Modifier Low / Median / High Price $377.03 / $562.74 / $937.90	Professional		$377.03	$562.74	$937.90