Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.83 / $298.83 / $298.83	Facility		$298.83	$298.83	$298.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.51 / $298.83 / $314.25	Professional		$255.51	$298.83	$314.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $392.46 / $392.46 / $392.46	Professional		$392.46	$392.46	$392.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $792.02 / $1,578.00 / $2,874.06	Facility		$792.02	$1,578.00	$2,874.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $497.12 / $523.28 / $706.43	Professional		$497.12	$523.28	$706.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $340.13 / $340.13 / $340.13	Facility		$340.13	$340.13	$340.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $418.62 / $418.62 / $418.62	Professional		$418.62	$418.62	$418.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.50 / $338.50 / $338.50	Facility		$338.50	$338.50	$338.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.50 / $338.50 / $606.75	Professional		$338.50	$338.50	$606.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $298.83 / $378.14 / $378.14	Facility		$298.83	$378.14	$378.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $293.30 / $378.14 / $549.44	Professional		$293.30	$378.14	$549.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $317.52 / $387.23 / $445.31	Professional		$317.52	$387.23	$445.31
United Facility/Professional Professional Modifier Low / Median / High Price $217.55 / $261.06 / $402.28	Professional		$217.55	$261.06	$402.28