Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.36 / $741.36 / $741.36	Facility		$741.36	$741.36	$741.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $617.79 / $741.36 / $741.36	Professional		$617.79	$741.36	$741.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $973.62 / $973.62 / $973.62	Professional		$973.62	$973.62	$973.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,964.84 / $3,914.73 / $7,130.01	Facility		$1,964.84	$3,914.73	$7,130.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,233.25 / $1,298.16 / $1,752.52	Professional		$1,233.25	$1,298.16	$1,752.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $823.58 / $843.80 / $848.35	Facility		$823.58	$843.80	$848.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,038.53 / $1,038.53 / $1,038.53	Professional		$1,038.53	$1,038.53	$1,038.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $724.63 / $724.63	Facility		$724.63	$724.63	$724.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.63 / $724.63 / $1,504.88	Professional		$724.63	$724.63	$1,504.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $741.36 / $938.11 / $938.11	Facility		$741.36	$938.11	$938.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $741.36 / $938.11 / $1,363.06	Professional		$741.36	$938.11	$1,363.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $816.54 / $960.64 / $1,104.73	Professional		$816.54	$960.64	$1,104.73
United Facility/Professional Professional Modifier Low / Median / High Price $482.12 / $620.60 / $929.12	Professional		$482.12	$620.60	$929.12