Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $512.86	Professional		$275.42	$354.81	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $489.78 / $691.83	Professional		$436.52	$489.78	$691.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $2,089.30 / $3,981.07	Facility		$870.96	$2,089.30	$3,981.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $691.83 / $724.44	Professional		$660.69	$691.83	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $812.83	Professional		$338.84	$457.09	$812.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,318.26 / $1,479.11	Facility		$398.11	$1,318.26	$1,479.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $851.14	Professional		$338.84	$524.81	$851.14
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $489.78	Professional		$338.84	$457.09	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $549.54 / $831.76	Facility		$363.08	$549.54	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $478.63	Professional		$251.19	$331.13	$478.63