Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.19 / $1,804.66 / $2,758.86	Facility		$387.19	$1,804.66	$2,758.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $321.61 / $387.19 / $387.19	Professional		$321.61	$387.19	$387.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $677.99 / $677.99 / $677.99	Professional		$677.99	$677.99	$677.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,026.18 / $2,044.55 / $3,723.79	Facility		$1,026.18	$2,044.55	$3,723.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $644.09 / $677.99 / $915.29	Professional		$644.09	$677.99	$915.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $430.12 / $440.69 / $443.07	Facility		$430.12	$440.69	$443.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $542.39 / $542.39 / $542.39	Professional		$542.39	$542.39	$542.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.48 / $419.48 / $419.48	Facility		$419.48	$419.48	$419.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.48 / $419.48 / $786.00	Professional		$419.48	$419.48	$786.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $489.94 / $1,804.66 / $2,758.86	Facility		$489.94	$1,804.66	$2,758.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $364.16 / $489.94 / $779.68	Professional		$364.16	$489.94	$779.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $426.45 / $501.71 / $576.96	Professional		$426.45	$501.71	$576.96
United Facility/Professional Professional Modifier Low / Median / High Price $236.58 / $318.38 / $485.24	Professional		$236.58	$318.38	$485.24