Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $617.40 / $617.40	Facility		$617.40	$617.40	$617.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $521.72 / $580.66 / $617.40	Professional		$521.72	$580.66	$617.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $810.82 / $810.82 / $815.19	Professional		$810.82	$810.82	$815.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,636.30 / $3,260.14 / $5,937.78	Facility		$1,636.30	$3,260.14	$5,937.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,027.04 / $1,081.08 / $1,459.47	Professional		$1,027.04	$1,081.08	$1,459.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $685.85 / $702.71 / $706.50	Facility		$685.85	$702.71	$706.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $864.87 / $864.87 / $864.87	Professional		$864.87	$864.87	$864.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $702.03 / $702.03 / $702.03	Facility		$702.03	$702.03	$702.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $702.03 / $702.03 / $1,253.25	Professional		$702.03	$702.03	$1,253.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $781.23 / $781.23	Facility		$617.40	$781.23	$781.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $580.03 / $781.23 / $1,243.25	Professional		$580.03	$781.23	$1,243.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $656.00 / $800.01 / $920.01	Professional		$656.00	$800.01	$920.01
United Facility/Professional Professional Modifier Low / Median / High Price $377.25 / $507.68 / $764.14	Professional		$377.25	$507.68	$764.14