Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.52 / $136.52 / $385.72	Facility		$136.52	$136.52	$385.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.59 / $136.52 / $340.00	Professional		$120.59	$136.52	$340.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.29 / $179.29 / $179.29	Professional		$179.29	$179.29	$179.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $361.82 / $720.88 / $1,312.96	Facility		$361.82	$720.88	$1,312.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.10 / $239.05 / $322.72	Professional		$227.10	$239.05	$322.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.65 / $233.30 / $355.05	Facility		$151.65	$233.30	$355.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $191.24 / $310.77 / $336.48	Professional		$191.24	$310.77	$336.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.55 / $152.55 / $153.72	Facility		$152.55	$152.55	$153.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.55 / $152.55 / $277.13	Professional		$152.55	$152.55	$277.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $136.52 / $172.74 / $385.72	Facility		$136.52	$172.74	$385.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.25 / $172.74 / $298.81	Professional		$128.25	$172.74	$298.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.05 / $176.90 / $203.43	Professional		$145.05	$176.90	$203.43
United Facility/Professional Professional Modifier Low / Median / High Price $83.41 / $112.25 / $171.09	Professional		$83.41	$112.25	$171.09