Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.49 / $213.68 / $377.00	Facility		$88.49	$213.68	$377.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.97 / $169.59 / $231.04	Professional		$146.97	$169.59	$231.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $238.86 / $238.86 / $238.86	Professional		$238.86	$238.86	$238.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.47 / $895.51 / $1,631.02	Facility		$449.47	$895.51	$1,631.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.11 / $296.95 / $400.90	Professional		$282.11	$296.95	$400.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $188.41 / $193.02 / $194.10	Facility		$188.41	$193.02	$194.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $237.57 / $237.57 / $237.57	Professional		$237.57	$237.57	$237.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $175.00 / $175.00	Facility		$175.00	$175.00	$175.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.21 / $175.00 / $344.25	Professional		$150.21	$175.00	$344.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $88.49 / $214.60 / $377.00	Facility		$88.49	$214.60	$377.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $214.60 / $331.08	Professional		$159.34	$214.60	$331.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.78 / $219.75 / $252.71	Professional		$186.78	$219.75	$252.71
United Facility/Professional Facility Modifier Low / Median / High Price $300.68 / $353.74 / $353.74	Facility		$300.68	$353.74	$353.74
United Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $139.46 / $212.54	Professional		$103.64	$139.46	$212.54