Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $513.98 / $513.98 / $513.98	Facility		$513.98	$513.98	$513.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.32 / $513.98 / $559.26	Professional		$428.32	$513.98	$559.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $674.99 / $674.99 / $674.99	Professional		$674.99	$674.99	$674.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,362.19 / $2,714.01 / $4,943.10	Facility		$1,362.19	$2,714.01	$4,943.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $854.99 / $899.99 / $1,214.99	Professional		$854.99	$899.99	$1,214.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $560.95 / $560.95 / $584.99	Facility		$560.95	$560.95	$584.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $719.99 / $719.99 / $719.99	Professional		$719.99	$719.99	$719.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $582.20 / $582.20	Facility		$582.20	$582.20	$582.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $582.20 / $582.20 / $1,043.25	Professional		$582.20	$582.20	$1,043.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $513.98 / $650.39 / $650.39	Facility		$513.98	$650.39	$650.39
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $513.98 / $650.39 / $1,012.27	Professional		$513.98	$650.39	$1,012.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $380.66	Professional		$30.00	$30.00	$380.66
United Facility/Professional Facility Modifier Low / Median / High Price $500.36 / $500.36 / $500.36	Facility		$500.36	$500.36	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $358.79 / $430.54 / $663.45	Professional		$358.79	$430.54	$663.45