Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.25 / $248.25 / $873.29	Facility		$248.25	$248.25	$873.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.26 / $248.25 / $281.70	Professional		$212.26	$248.25	$281.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $326.02 / $434.70 / $434.70	Professional		$326.02	$434.70	$434.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $657.94 / $1,310.88 / $2,387.55	Facility		$657.94	$1,310.88	$2,387.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.97 / $434.70 / $586.85	Professional		$412.97	$434.70	$586.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $282.56 / $282.56 / $284.56	Facility		$282.56	$282.56	$284.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $347.76 / $347.76 / $347.76	Professional		$347.76	$347.76	$347.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.20 / $281.20 / $281.20	Facility		$281.20	$281.20	$281.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.20 / $281.20 / $504.00	Professional		$281.20	$281.20	$504.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $314.14 / $696.38 / $873.29	Facility		$314.14	$696.38	$873.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $248.25 / $314.14 / $456.43	Professional		$248.25	$314.14	$456.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $263.77 / $321.68 / $369.93	Professional		$263.77	$321.68	$369.93
United Facility/Professional Professional Modifier Low / Median / High Price $180.72 / $216.86 / $334.19	Professional		$180.72	$216.86	$334.19