Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.35 / $657.77 / $809.41	Facility		$168.35	$657.77	$809.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.28 / $168.35 / $168.35	Professional		$143.28	$168.35	$168.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.09 / $221.09 / $221.09	Professional		$221.09	$221.09	$221.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.17 / $888.94 / $1,619.05	Facility		$446.17	$888.94	$1,619.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.04 / $294.77 / $397.95	Professional		$280.04	$294.77	$397.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $191.61 / $191.61 / $191.61	Facility		$191.61	$191.61	$191.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $235.82 / $235.82 / $235.82	Professional		$235.82	$235.82	$235.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.69 / $190.69 / $190.69	Facility		$190.69	$190.69	$190.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.69 / $190.69 / $341.63	Professional		$190.69	$190.69	$341.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $213.02 / $657.77 / $809.41	Facility		$213.02	$657.77	$809.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $165.54 / $213.02 / $337.77	Professional		$165.54	$213.02	$337.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.87 / $218.14 / $250.86	Professional		$178.87	$218.14	$250.86
United Facility/Professional Professional Modifier Low / Median / High Price $115.15 / $140.93 / $210.98	Professional		$115.15	$140.93	$210.98