Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $644.75 / $644.75 / $644.75	Facility		$644.75	$644.75	$644.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $569.53 / $644.75 / $678.94	Professional		$569.53	$644.75	$678.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $846.74 / $846.74 / $846.74	Professional		$846.74	$846.74	$846.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,708.78 / $3,404.55 / $6,200.81	Facility		$1,708.78	$3,404.55	$6,200.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,072.53 / $1,128.98 / $1,524.12	Professional		$1,072.53	$1,128.98	$1,524.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $729.34 / $733.84 / $840.79	Facility		$729.34	$733.84	$840.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $903.18 / $903.18 / $903.18	Professional		$903.18	$903.18	$903.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $773.33	Facility		$700.00	$700.00	$773.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $700.00 / $1,308.75	Professional		$700.00	$700.00	$1,308.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $644.75 / $815.86 / $815.86	Facility		$644.75	$815.86	$815.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $617.22 / $815.86 / $1,185.42	Professional		$617.22	$815.86	$1,185.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $685.06 / $835.45 / $960.76	Professional		$685.06	$835.45	$960.76
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $401.43 / $530.17 / $808.05	Professional		$401.43	$530.17	$808.05