Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $671.63 / $671.63 / $671.63	Facility		$671.63	$671.63	$671.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.08 / $671.63 / $671.63	Professional		$505.08	$671.63	$671.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,176.04 / $1,176.04 / $1,176.04	Professional		$1,176.04	$1,176.04	$1,176.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,780.01 / $3,546.47 / $6,459.28	Facility		$1,780.01	$3,546.47	$6,459.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,117.24 / $1,176.04 / $1,587.65	Professional		$1,117.24	$1,176.04	$1,587.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $622.48 / $622.48 / $764.43	Facility		$622.48	$622.48	$764.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $940.83 / $940.83 / $940.83	Professional		$940.83	$940.83	$940.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $694.09 / $694.09 / $694.09	Facility		$694.09	$694.09	$694.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $694.09 / $694.09 / $1,363.50	Professional		$694.09	$694.09	$1,363.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $671.63 / $849.87 / $849.87	Facility		$671.63	$849.87	$849.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $659.08 / $849.87 / $1,234.83	Professional		$659.08	$849.87	$1,234.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $713.62 / $870.27 / $1,000.81	Professional		$713.62	$870.27	$1,000.81
United Facility/Professional Professional Modifier Low / Median / High Price $398.14 / $562.22 / $841.72	Professional		$398.14	$562.22	$841.72