Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $533.28 / $533.28 / $533.28	Facility		$533.28	$533.28	$533.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.96 / $533.28 / $569.86	Professional		$455.96	$533.28	$569.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $700.35 / $700.35 / $700.35	Professional		$700.35	$700.35	$700.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,413.36 / $2,815.97 / $5,128.80	Facility		$1,413.36	$2,815.97	$5,128.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $887.11 / $933.80 / $1,260.63	Professional		$887.11	$933.80	$1,260.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $606.97 / $611.88 / $661.10	Facility		$606.97	$611.88	$661.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $747.04 / $747.04 / $747.04	Professional		$747.04	$747.04	$747.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $583.49 / $583.49 / $583.49	Facility		$583.49	$583.49	$583.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $583.49 / $583.49 / $1,082.63	Professional		$583.49	$583.49	$1,082.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $533.28 / $674.81 / $674.81	Facility		$533.28	$674.81	$674.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $533.28 / $674.81 / $1,042.85	Professional		$533.28	$674.81	$1,042.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $566.62 / $691.01 / $794.66	Professional		$566.62	$691.01	$794.66
United Facility/Professional Facility Modifier Low / Median / High Price $466.72 / $466.72 / $466.72	Facility		$466.72	$466.72	$466.72
United Facility/Professional Professional Modifier Low / Median / High Price $388.22 / $465.86 / $717.88	Professional		$388.22	$465.86	$717.88