Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.38 / $204.38 / $789.05	Facility		$204.38	$204.38	$789.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.32 / $204.38 / $216.25	Professional		$170.32	$204.38	$216.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $268.41 / $357.88 / $357.88	Professional		$268.41	$357.88	$357.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $541.67 / $1,079.22 / $1,965.62	Facility		$541.67	$1,079.22	$1,965.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.99 / $357.88 / $483.14	Professional		$339.99	$357.88	$483.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.89 / $216.89 / $232.62	Facility		$216.89	$216.89	$232.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $286.30 / $286.30 / $286.30	Professional		$286.30	$286.30	$286.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.59 / $209.59 / $209.59	Facility		$209.59	$209.59	$209.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.59 / $209.59 / $414.75	Professional		$209.59	$209.59	$414.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $258.62 / $629.69 / $789.05	Facility		$258.62	$629.69	$789.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $200.64 / $258.62 / $429.45	Professional		$200.64	$258.62	$429.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.16 / $264.83 / $304.55	Professional		$217.16	$264.83	$304.55
United Facility/Professional Facility Modifier Low / Median / High Price $2.75 / $219.98 / $250.82	Facility		$2.75	$219.98	$250.82
United Facility/Professional Professional Modifier Low / Median / High Price $138.72 / $171.08 / $256.52	Professional		$138.72	$171.08	$256.52