Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $281.84 / $416.87	Facility		$131.83	$281.84	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $239.88	Professional		$93.33	$128.82	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $141.25	Professional		$89.13	$89.13	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $158.49	Facility		$22.91	$22.91	$158.49
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	50	$190.55	$190.55	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $173.78	Professional		$107.15	$128.82	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $144.54 / $204.17	Facility		$112.20	$144.54	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $288.40	Professional		$120.23	$165.96	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $229.09	Professional		$93.33	$134.90	$229.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $316.23 / $407.38	Facility		$131.83	$316.23	$407.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $144.54 / $234.42	Professional		$97.72	$144.54	$234.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $213.80	Professional		$89.13	$125.89	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $851.14 / $1,737.80	Facility		$208.93	$851.14	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $186.21	Professional		$107.15	$141.25	$186.21