Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.74 / $113.74 / $113.74	Facility		$113.74	$113.74	$113.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.79 / $113.74 / $113.74	Professional		$94.79	$113.74	$113.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $149.38 / $149.38	Professional		$149.38	$149.38	$149.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $301.45 / $600.62 / $1,093.92	Facility		$301.45	$600.62	$1,093.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.21 / $199.17 / $268.88	Professional		$189.21	$199.17	$268.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.35 / $129.46 / $130.18	Facility		$126.35	$129.46	$130.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $159.34 / $159.34	Professional		$159.34	$159.34	$159.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $120.62 / $120.62	Facility		$120.62	$120.62	$120.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.62 / $120.62 / $231.00	Professional		$120.62	$120.62	$231.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $113.74 / $143.93 / $143.93	Facility		$113.74	$143.93	$143.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $113.74 / $143.93 / $209.12	Professional		$113.74	$143.93	$209.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.28 / $147.38 / $169.49	Professional		$125.28	$147.38	$169.49
United Facility/Professional Professional Modifier Low / Median / High Price $73.97 / $95.21 / $149.53	Professional		$73.97	$95.21	$149.53