Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.02 / $264.02 / $916.11	Facility		$264.02	$264.02	$916.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.03 / $264.02 / $264.02	Professional		$194.03	$264.02	$264.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.73 / $462.31 / $462.31	Professional		$346.73	$462.31	$462.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $699.74 / $1,394.14 / $2,539.19	Facility		$699.74	$1,394.14	$2,539.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $439.19 / $462.31 / $624.12	Professional		$439.19	$462.31	$624.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.38 / $265.52 / $300.50	Facility		$225.38	$265.52	$300.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $369.85 / $369.85 / $369.85	Professional		$369.85	$369.85	$369.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $232.98 / $232.98 / $232.98	Facility		$232.98	$232.98	$232.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.98 / $232.98 / $535.88	Professional		$232.98	$232.98	$535.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $334.09 / $916.11 / $1,148.47	Facility		$334.09	$916.11	$1,148.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $232.21 / $334.09 / $485.42	Professional		$232.21	$334.09	$485.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $280.53 / $342.11 / $393.42	Professional		$280.53	$342.11	$393.42
United Facility/Professional Professional Modifier Low / Median / High Price $172.98 / $217.10 / $330.89	Professional		$172.98	$217.10	$330.89