Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.60 / $156.58 / $457.00	Facility		$142.60	$156.58	$457.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.69 / $147.27 / $200.94	Professional		$135.69	$147.27	$200.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.64 / $206.76 / $274.19	Professional		$205.64	$206.76	$274.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $415.01 / $826.85 / $1,505.96	Facility		$415.01	$826.85	$1,505.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $260.48 / $274.19 / $370.16	Professional		$260.48	$274.19	$370.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.95 / $178.22 / $179.19	Facility		$173.95	$178.22	$179.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $219.35 / $219.35 / $219.35	Professional		$219.35	$219.35	$219.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $135.00 / $135.00	Facility		$135.00	$135.00	$135.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $135.00 / $318.00	Professional		$135.00	$135.00	$318.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $142.60 / $198.13 / $457.00	Facility		$142.60	$198.13	$457.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $147.11 / $198.13 / $287.89	Professional		$147.11	$198.13	$287.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $172.46 / $202.90 / $233.33	Professional		$172.46	$202.90	$233.33
United Facility/Professional Professional Modifier Low / Median / High Price $95.68 / $128.75 / $196.24	Professional		$95.68	$128.75	$196.24