Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $2,931.56 / $2,934.36	Facility		$614.00	$2,931.56	$2,934.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $510.04 / $614.00 / $614.00	Professional		$510.04	$614.00	$614.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $604.77 / $604.77 / $604.77	Professional		$604.77	$604.77	$604.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,627.29 / $3,242.19 / $5,905.10	Facility		$1,627.29	$3,242.19	$5,905.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,021.38 / $1,075.14 / $1,451.44	Professional		$1,021.38	$1,075.14	$1,451.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $682.11 / $698.84 / $702.65	Facility		$682.11	$698.84	$702.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $860.11 / $860.11 / $860.11	Professional		$860.11	$860.11	$860.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $731.38 / $860.28	Facility		$731.38	$731.38	$860.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $543.63 / $731.38 / $1,246.50	Professional		$543.63	$731.38	$1,246.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $776.97 / $1,467.18 / $2,934.36	Facility		$776.97	$1,467.18	$2,934.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $577.47 / $776.97 / $1,128.89	Professional		$577.47	$776.97	$1,128.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $795.60 / $914.94	Professional		$75.00	$795.60	$914.94
United Facility/Professional Professional Modifier Low / Median / High Price $375.18 / $504.90 / $769.52	Professional		$375.18	$504.90	$769.52