Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.35 / $925.28 / $1,210.24	Facility		$173.35	$925.28	$1,210.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.49 / $163.03 / $173.35	Professional		$149.49	$163.03	$173.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $227.65 / $227.65 / $227.65	Professional		$227.65	$227.65	$227.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $459.41 / $915.33 / $1,667.11	Facility		$459.41	$915.33	$1,667.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.35 / $303.52 / $409.77	Professional		$288.35	$303.52	$409.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.23 / $173.23 / $197.29	Facility		$173.23	$173.23	$197.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $242.82 / $242.82 / $242.82	Professional		$242.82	$242.82	$242.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $175.81 / $191.33	Facility		$175.81	$175.81	$191.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.81 / $175.81 / $351.75	Professional		$175.81	$175.81	$351.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $219.36 / $925.28 / $1,210.24	Facility		$219.36	$925.28	$1,210.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $160.06 / $219.36 / $318.70	Professional		$160.06	$219.36	$318.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.18 / $224.61 / $258.30	Professional		$184.18	$224.61	$258.30
United Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $142.55 / $217.26	Professional		$104.10	$142.55	$217.26