Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $451.55 / $451.55 / $2,548.26	Facility		$451.55	$451.55	$2,548.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.12 / $451.55 / $451.55	Professional		$374.12	$451.55	$451.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $593.01 / $790.68 / $790.68	Professional		$593.01	$790.68	$790.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.74 / $2,384.37 / $4,342.72	Facility		$1,196.74	$2,384.37	$4,342.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $751.15 / $790.68 / $1,067.42	Professional		$751.15	$790.68	$1,067.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $456.75 / $462.26 / $513.94	Facility		$456.75	$462.26	$513.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $632.54 / $632.54 / $632.54	Professional		$632.54	$632.54	$632.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.05 / $440.05 / $440.05	Facility		$440.05	$440.05	$440.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $440.05 / $440.05 / $916.50	Professional		$440.05	$440.05	$916.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $451.55 / $571.39 / $2,548.26	Facility		$451.55	$571.39	$2,548.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $421.35 / $571.39 / $830.21	Professional		$421.35	$571.39	$830.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $479.78 / $585.10 / $672.86	Professional		$479.78	$585.10	$672.86
United Facility/Professional Professional Modifier Low / Median / High Price $277.85 / $378.00 / $565.90	Professional		$277.85	$378.00	$565.90