Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.55 / $322.55 / $1,166.72	Facility		$322.55	$322.55	$1,166.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.91 / $303.36 / $322.55	Professional		$267.91	$303.36	$322.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $390.00 / $390.00 / $390.00	Professional		$390.00	$390.00	$390.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $854.86 / $1,703.21 / $3,102.11	Facility		$854.86	$1,703.21	$3,102.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $536.55 / $564.79 / $762.48	Professional		$536.55	$564.79	$762.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $367.12 / $369.08	Facility		$358.29	$367.12	$369.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $451.84 / $451.84 / $451.84	Professional		$451.84	$451.84	$451.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.25 / $315.25 / $315.25	Facility		$315.25	$315.25	$315.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.25 / $315.25 / $654.75	Professional		$315.25	$315.25	$654.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $322.55 / $408.14 / $1,166.72	Facility		$322.55	$408.14	$1,166.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $303.00 / $408.14 / $576.09	Professional		$303.00	$408.14	$576.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $355.25 / $417.95 / $480.64	Professional		$355.25	$417.95	$480.64
United Facility/Professional Professional Modifier Low / Median / High Price $197.07 / $265.22 / $399.19	Professional		$197.07	$265.22	$399.19