Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.70 / $363.70 / $987.01	Facility		$363.70	$363.70	$987.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $310.95 / $363.70 / $412.70	Professional		$310.95	$363.70	$412.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $477.63 / $477.63 / $477.63	Professional		$477.63	$477.63	$477.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $963.90 / $1,920.45 / $3,497.78	Facility		$963.90	$1,920.45	$3,497.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $605.00 / $636.84 / $859.73	Professional		$605.00	$636.84	$859.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $413.95 / $413.95 / $413.95	Facility		$413.95	$413.95	$413.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $509.47 / $509.47 / $509.47	Professional		$509.47	$509.47	$509.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $397.94 / $397.94 / $397.94	Facility		$397.94	$397.94	$397.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.94 / $397.94 / $738.38	Professional		$397.94	$397.94	$738.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $460.21 / $881.71 / $987.01	Facility		$460.21	$881.71	$987.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $363.70 / $460.21 / $668.68	Professional		$363.70	$460.21	$668.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $386.43 / $471.26 / $541.94	Professional		$386.43	$471.26	$541.94
United Facility/Professional Professional Modifier Low / Median / High Price $264.76 / $317.70 / $489.58	Professional		$264.76	$317.70	$489.58