Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.02 / $186.02 / $186.02	Facility		$186.02	$186.02	$186.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $186.02 / $288.27	Professional		$140.94	$186.02	$288.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.31 / $303.33 / $403.08	Professional		$302.31	$303.33	$403.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $399.51 / $795.97 / $1,449.72	Facility		$399.51	$795.97	$1,449.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.75 / $263.95 / $356.33	Professional		$250.75	$263.95	$356.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $171.57 / $171.57 / $202.11	Facility		$171.57	$171.57	$202.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $211.16 / $211.16 / $211.16	Professional		$211.16	$211.16	$211.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $301.51 / $301.51 / $301.51	Facility		$301.51	$301.51	$301.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.51 / $301.51 / $411.77	Professional		$301.51	$301.51	$411.77
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $108.49 / $108.49 / $186.02	Facility		$108.49	$108.49	$186.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $108.49 / $186.02 / $326.48	Professional		$108.49	$186.02	$326.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $298.27 / $343.02	Professional		$253.53	$298.27	$343.02
United Facility/Professional Professional Modifier Low / Median / High Price $155.86 / $232.56 / $387.60	Professional		$155.86	$232.56	$387.60