Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.10 / $122.21 / $464.00	Facility		$27.10	$122.21	$464.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.82 / $36.28 / $62.97	Professional		$22.82	$36.28	$62.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.44 / $46.44 / $46.44	Professional	50	$46.44	$46.44	$46.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $19.39 / $19.39	Professional		$19.39	$19.39	$19.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.46 / $127.58 / $172.84	Facility		$109.46	$127.58	$172.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.74 / $18.13 / $34.85	Professional		$4.74	$18.13	$34.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.63 / $27.16 / $63.05	Facility		$22.63	$27.16	$63.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $45.84 / $68.33	Professional		$43.11	$45.84	$68.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.31 / $39.26 / $97.83	Professional		$21.31	$39.26	$97.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $26.27 / $116.51 / $2,056.00	Facility		$26.27	$116.51	$2,056.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.80 / $42.89 / $61.85	Professional		$25.80	$42.89	$61.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $67.87 / $95.12	Professional		$54.90	$67.87	$95.12
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $49.09 / $64.92	Professional		$41.90	$49.09	$64.92