Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $4,570.88 / $4,570.88	Facility		$776.25	$4,570.88	$4,570.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $977.24	Professional		$489.78	$660.69	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $4,073.80 / $7,762.47	Facility		$1,698.24	$4,073.80	$7,762.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,348.96 / $1,412.54	Professional		$1,288.25	$1,348.96	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $1,584.89	Professional		$562.34	$776.25	$1,584.89
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $2,570.40 / $4,570.88	Facility		$776.25	$2,570.40	$4,570.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,047.13 / $1,659.59	Professional		$630.96	$1,047.13	$1,659.59
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $812.83	Professional		$562.34	$776.25	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,071.52 / $1,412.54	Facility		$354.81	$1,071.52	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $630.96 / $912.01	Professional		$436.52	$630.96	$912.01