Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.97 / $439.68 / $1,075.46	Facility		$240.97	$439.68	$1,075.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.81 / $240.97 / $245.38	Professional		$200.81	$240.97	$245.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $316.45 / $316.45 / $316.47	Professional		$316.45	$316.45	$316.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.65 / $1,272.43 / $2,317.52	Facility		$638.65	$1,272.43	$2,317.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.85 / $421.95 / $569.63	Professional		$400.85	$421.95	$569.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $252.62 / $257.27 / $274.27	Facility		$252.62	$257.27	$274.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $337.56 / $337.56 / $337.56	Professional		$337.56	$337.56	$337.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $296.00 / $301.92	Facility		$296.00	$296.00	$301.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.00 / $296.00 / $489.00	Professional		$296.00	$296.00	$489.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $439.68 / $1,075.46	Facility		$245.30	$439.68	$1,075.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $206.58 / $304.92 / $431.25	Professional		$206.58	$304.92	$431.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $256.03 / $312.24 / $359.07	Professional		$256.03	$312.24	$359.07
United Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $201.72 / $316.77	Professional		$157.43	$201.72	$316.77