Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.81 / $282.82 / $715.34	Facility		$282.81	$282.82	$715.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.11 / $265.99 / $282.82	Professional		$245.11	$265.99	$282.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $371.42 / $371.42 / $495.23	Professional		$371.42	$371.42	$495.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $749.56 / $1,493.42 / $2,720.00	Facility		$749.56	$1,493.42	$2,720.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $470.47 / $495.23 / $668.56	Professional		$470.47	$495.23	$668.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $314.22 / $321.89 / $323.68	Facility		$314.22	$321.89	$323.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $396.18 / $396.18 / $396.18	Professional		$396.18	$396.18	$396.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $312.81 / $312.81 / $312.81	Facility		$312.81	$312.81	$312.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.35 / $312.81 / $574.13	Professional		$250.35	$312.81	$574.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $282.81 / $357.87 / $715.34	Facility		$282.81	$357.87	$715.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $265.79 / $357.87 / $519.99	Professional		$265.79	$357.87	$519.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $300.50 / $366.47 / $421.44	Professional		$300.50	$366.47	$421.44
United Facility/Professional Professional Modifier Low / Median / High Price $183.99 / $232.56 / $354.44	Professional		$183.99	$232.56	$354.44