Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $278.58 / $278.58 / $278.58	Facility		$278.58	$278.58	$278.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.44 / $278.58 / $278.58	Professional		$241.44	$278.58	$278.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $365.85 / $365.85 / $487.80	Professional		$365.85	$365.85	$487.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.32 / $1,471.01 / $2,679.19	Facility		$738.32	$1,471.01	$2,679.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $463.41 / $487.80 / $658.53	Professional		$463.41	$487.80	$658.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $296.08 / $317.07 / $337.21	Facility		$296.08	$317.07	$337.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $390.24 / $390.24 / $390.24	Professional		$390.24	$390.24	$390.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $297.02 / $297.02	Facility		$297.02	$297.02	$297.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.02 / $297.02 / $565.50	Professional		$297.02	$297.02	$565.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $278.58 / $352.50 / $352.50	Facility		$278.58	$352.50	$352.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $272.52 / $352.50 / $512.19	Professional		$272.52	$352.50	$512.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $295.99 / $360.97 / $415.11	Professional		$295.99	$360.97	$415.11
United Facility/Professional Professional Modifier Low / Median / High Price $177.94 / $229.07 / $349.12	Professional		$177.94	$229.07	$349.12