Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.10 / $346.09 / $431.10	Facility		$109.10	$346.09	$431.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.55 / $106.86 / $145.10	Professional		$94.55	$106.86	$145.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $143.28 / $152.83	Professional		$79.89	$143.28	$152.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.14 / $576.10 / $1,049.27	Facility		$289.14	$576.10	$1,049.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.49 / $191.04 / $257.89	Professional		$181.49	$191.04	$257.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.18 / $186.43 / $283.74	Facility		$121.18	$186.43	$283.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.83 / $248.35 / $268.87	Professional		$152.83	$248.35	$268.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $120.81 / $120.81	Facility		$118.47	$120.81	$120.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.47 / $120.81 / $221.63	Professional		$118.47	$120.81	$221.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $346.09 / $422.65	Facility		$81.06	$346.09	$422.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $109.10 / $191.04	Professional		$81.06	$109.10	$191.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.16 / $141.37 / $162.57	Professional		$120.16	$141.37	$162.57
United Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $89.71 / $142.47	Professional		$66.66	$89.71	$142.47