Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $2,041.74 / $4,897.79	Facility		$173.78	$2,041.74	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $380.19	Professional		$107.15	$173.78	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $199.53	Professional		$120.23	$147.91	$199.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $125.89	Facility		$89.13	$89.13	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $151.36 / $213.80	Professional		$28.18	$151.36	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $575.44	Professional		$117.49	$173.78	$575.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,584.89 / $4,897.79	Facility		$169.82	$1,584.89	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $295.12	Professional		$114.82	$173.78	$295.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $501.19	Professional		$112.20	$154.88	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,019.95 / $6,025.60	Facility		$1,258.93	$3,019.95	$6,025.60
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $208.93	Professional		$117.49	$158.49	$208.93