Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.17 / $301.17 / $805.90	Facility		$301.17	$301.17	$805.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.50 / $301.17 / $341.75	Professional		$257.50	$301.17	$341.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $395.52 / $395.52 / $395.52	Professional		$395.52	$395.52	$395.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $798.19 / $1,590.31 / $2,896.47	Facility		$798.19	$1,590.31	$2,896.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.99 / $527.36 / $711.94	Professional		$500.99	$527.36	$711.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $342.78 / $342.78 / $418.70	Facility		$342.78	$342.78	$418.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $421.89 / $421.89 / $421.89	Professional		$421.89	$421.89	$421.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.53 / $329.53 / $329.53	Facility		$329.53	$329.53	$329.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.53 / $329.53 / $611.25	Professional		$329.53	$329.53	$611.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $381.09 / $719.55 / $805.90	Facility		$381.09	$719.55	$805.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $301.17 / $381.09 / $553.72	Professional		$301.17	$381.09	$553.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $320.00 / $390.25 / $448.78	Professional		$320.00	$390.25	$448.78
United Facility/Professional Professional Modifier Low / Median / High Price $219.25 / $263.08 / $405.42	Professional		$219.25	$263.08	$405.42