Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $443.29 / $443.29 / $443.29	Facility		$443.29	$443.29	$443.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.70 / $443.29 / $443.29	Professional		$362.70	$443.29	$443.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $776.22 / $776.22 / $776.22	Professional		$776.22	$776.22	$776.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.85 / $2,340.77 / $4,263.31	Facility		$1,174.85	$2,340.77	$4,263.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $737.41 / $776.22 / $1,047.90	Professional		$737.41	$776.22	$1,047.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $444.43 / $447.01 / $504.54	Facility		$444.43	$447.01	$504.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $620.98 / $620.98 / $620.98	Professional		$620.98	$620.98	$620.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $427.25 / $427.25 / $427.25	Facility		$427.25	$427.25	$427.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.25 / $427.25 / $900.00	Professional		$427.25	$427.25	$900.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $443.29 / $560.95 / $560.95	Facility		$443.29	$560.95	$560.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $410.16 / $560.95 / $815.03	Professional		$410.16	$560.95	$815.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $471.00 / $574.40 / $660.56	Professional		$471.00	$574.40	$660.56
United Facility/Professional Professional Modifier Low / Median / High Price $284.26 / $371.09 / $555.55	Professional		$284.26	$371.09	$555.55