Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.58 / $262.55 / $529.30	Facility		$156.58	$262.55	$529.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.53 / $156.58 / $296.39	Professional		$143.53	$156.58	$296.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.64 / $205.64 / $274.19	Professional		$205.64	$205.64	$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 / $267.62 / $407.25	Facility		$173.95	$267.62	$407.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $219.35 / $356.45 / $385.95	Professional		$219.35	$356.45	$385.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $146.03	Facility		$142.00	$142.00	$146.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $142.00 / $318.00	Professional		$142.00	$142.00	$318.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $176.46 / $262.55 / $529.30	Facility		$176.46	$262.55	$529.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $153.37 / $176.46 / $288.33	Professional		$153.37	$176.46	$288.33
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 $101.83 / $128.75 / $214.59	Professional		$101.83	$128.75	$214.59