Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.99 / $492.80 / $551.77	Facility		$245.99	$492.80	$551.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.49 / $245.99 / $271.89	Professional		$225.49	$245.99	$271.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $430.74 / $430.74 / $430.74	Professional		$430.74	$430.74	$430.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $651.95 / $1,298.94 / $2,365.80	Facility		$651.95	$1,298.94	$2,365.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.20 / $430.74 / $581.50	Professional		$409.20	$430.74	$581.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $267.51 / $273.69 / $279.98	Facility		$267.51	$273.69	$279.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $344.59 / $344.59 / $344.59	Professional		$344.59	$344.59	$344.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $261.02 / $264.44 / $264.44	Facility		$261.02	$264.44	$264.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.02 / $264.44 / $499.50	Professional		$261.02	$264.44	$499.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $311.26 / $492.80 / $551.77	Facility		$311.26	$492.80	$551.77
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $243.71 / $311.26 / $464.69	Professional		$243.71	$311.26	$464.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $261.37 / $318.75 / $366.56	Professional		$261.37	$318.75	$366.56
United Facility/Professional Professional Modifier Low / Median / High Price $160.76 / $205.32 / $308.27	Professional		$160.76	$205.32	$308.27