Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $534.74 / $534.74 / $534.74	Facility		$534.74	$534.74	$534.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.41 / $534.74 / $534.74	Professional		$378.41	$534.74	$534.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $702.26 / $702.26 / $702.26	Professional		$702.26	$702.26	$702.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,417.23 / $2,823.66 / $5,142.81	Facility		$1,417.23	$2,823.66	$5,142.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $889.53 / $936.35 / $1,264.07	Professional		$889.53	$936.35	$1,264.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $494.38 / $497.00 / $608.63	Facility		$494.38	$497.00	$608.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $749.08 / $749.08 / $749.08	Professional		$749.08	$749.08	$749.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.31 / $663.31 / $663.31	Facility		$663.31	$663.31	$663.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.31 / $663.31 / $1,085.63	Professional		$663.31	$663.31	$1,085.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $534.74 / $676.64 / $676.64	Facility		$534.74	$676.64	$676.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $534.74 / $676.64 / $983.16	Professional		$534.74	$676.64	$983.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $568.17 / $692.90 / $796.83	Professional		$568.17	$692.90	$796.83
United Facility/Professional Professional Modifier Low / Median / High Price $316.20 / $447.63 / $661.77	Professional		$316.20	$447.63	$661.77